University of California Berkeley Warren Institute: Safety Net ACOs – Federal Statutory and Regulatory Issues

This policy brief from the University of California Berkeley School of Law’s Warren Institute examines the federal legal and regulatory issues for Medicare accountable care organizations (ACOs) and their implications for safety net health care organizations, including community health centers.  The policy brief was released before the Centers for Medicare and Medicaid Services (CMS) issued its final rule for the Medicare Shared Savings ACO Program and highlights the legal issues that pose barriers and challenges for safety net organizations participating in ACOs, especially fraud and abuse, anti-trust, and tax issues.   While there was some clarification of these issues in the Medicare Shared Savings Program final rule and accompanying final guidances issued by the Department of Health and Human Services Office of Inspector General, Department of Justice, Federal Trade Commission, and Internal Revenue Service, the policy brief remains relevant for safety net organizations participating in ACOs.

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