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HHS/CMS RIN: 0938-AS67 Publication ID: Fall 2016 
Title: Medicare Shared Savings Program; Accountable Care Organizations (ACOs)--Revised Benchmark Rebasing Methodology (CMS-1644-F)(Completion of a Section 610 Review) 
Abstract:

Under the Medicare Shared Savings Program, providers of services and suppliers that participate in an ACO continue to receive traditional Medicare fee-for-service (FFS) payments under parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. This rule addresses changes to the Shared Savings Program that modify the program's benchmark rebasing methodology to encourage ACOs' continued investment in care coordination and quality improvement, and identifies publicly available data to support modeling and analysis of these changes. In addition, it streamlines the methodology used to adjust an ACO's historical benchmark for changes in its ACO participant composition, offers an alternative participation option to encourage ACOs to enter performance-based risk arrangements earlier in their participation under the program, and establishes policies for reopening of payment determinations to make corrections after financial calculations have been performed and ACO shared savings and shared losses for a performance year have been determined.

 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Completed Actions 
Major: Yes  Unfunded Mandates: No 
RFA Section 610 Review: Completion of a Section 610 Review 
CFR Citation: 42 CFR 425   
Legal Authority: Pub. L. 111-148 sec. 3022   
Legal Deadline:
Action Source Description Date
Final  Statutory  MMA section 902.  02/03/2019 
Timetable:
Action Date FR Cite
NPRM  02/03/2016  81 FR 5823   
NPRM Comment Period End  03/28/2016 
Final Action  06/10/2016  81 FR 37950   
Final Action Effective  08/09/2016 
Regulatory Flexibility Analysis Required: Yes  Government Levels Affected: None 
Small Entities Affected: Businesses, Organizations  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: Yes 
Related RINs: Split from 0938-AS06 
Agency Contact:
Elizabeth November
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare, MS: C5-15-24, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-8084
Email: elizabeth.november@cms.hhs.gov