The Federation of American Hospitals has asked federal regulators for some leeway regarding the construction of accountable care organizations (ACO news) in order to create a "level playing field," particularly regarding price fixing and physician kickback laws.
In an Oct. 27 letter from FAH to CMS, the FTC and the Office of the Inspector General, it has suggested a "safe harbor" from price fixing. "The absence of such a safe harbor will retard the spread and potential benefits of ACOs, both in Medicare and the commercial market ... most providers do not seek to organize themselves solely around participation in the Medicare program," the letter noted. "Second, the effort required to build an ACO solely for a Medicare population may be cost prohibitive."
The FAH has also suggested a waiver for ACOs from physician self-referral and kickback laws. "Depending on the particular innovative model and participating providers, the fraud and abuse authorities can be, at a minimum, an impediment and, at a maximum, a total barrier to the adoption of ACOs and other innovative care models," the letter read.
The FAH also expressed an opinion that measurable improvement standards should not be immediately set. "Such standards could stifle the very innovative efforts that the law was designed to incentivize to promote the coordination and efficiency of care delivery ... it is not known just what the right balance between measures might be, or what all the measures that might be used may achieve," the letter said. "Thus, this part of the program should be given time to develop."
For more:
- read the California Healthline article
- read the Becker's Hospital Review article