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Key Legal and Practical Considerations When Forming an ACO: Seizing the Opportunities and Overcoming Challenges to Achieve Quality and Savings

The long-awaiting Final Rule governing ACOs participating in the Medicare Shared Savings Program (MSSP) provides the industry with an improved outlook of the potential success that may be achieved, but also a daunting list of challenges to be met in order to seize the opportunities. This OnDemand Webinar will walk you through the legal, regulatory, policy, and practical challenges and solutions along the road to accountable care. Through constructive analysis of the Final Rule and guidance issued by CMS, DOJ, and the FTC, and the lessons learned from previous attempts at hospital-physician alignment, you will gain an in-depth look at the critical considerations every health care organization and provider must address for forming and implementing an ACO to achieve effective quality and savings.


Runtime: 91 minutes
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Agenda

Analyzing the Final Rule

  • Déjà Vu All Over Again?
    • Lessons Learned From Previous Models of HospitalPhysician Alignment
    • Distinguishing Current Market Factors, and Provider and Payor Relationships
  • Outlining Eligibility Requirements
    • Projected Cost Savings Estimates
    • Implementation Challenges
  • Waivers
    • Fraud and Abuse
    • Compliance Requirements

Considering the Costs and Benefits

  • Cost Projections
    • Development and Operational Estimates
    • Key Management and Functional Questions You Should Ask
  • One Size Does Not Fit All
    • Determining the Best Model Before You Apply
    • Application Process Procedures and Timeframes
    • CMS Policy Issues

Critical Antitrust Considerations

  • Overview of Antitrust Laws and Regulations
    • Protecting Competition
    • Rule of Reason Analysis
  • Two Key Questions to Ask When Forming an ACO
  • ACO Safety Zone and the Rural Exception
  • The Five Activities to Avoid
  • Voluntary Review Rules and Procedures
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More Program Information

Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Credits

OnDemand Webinar

This course was last revised on February 29, 2012.

Call 1-866-352-9540 for further credit information.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Audio & Reference Manual

  • Arizona CLE 1.5
     
  • CA MCLE 1.5
     
  • CT CLE 1.5
     
  • GA CLE 1.5
     
  • HI CLE 1.5
     
  • IL CLE 1.5
     
  • ME CLE 1.5
     
  • MT CLE 1.5
     
  • NJ CLE 1.8
     
  • NV CLE 1.5
     
  • VT CLE 1.5
     
  • WA CLE 1.5
     
  • WV MCLE 1.8
     
The CLE Code is ONLY a requirement when applying for CLE Credit in California (for participatory credit), Kansas, New Jersey or New York. Other states do not need to supply the CLE Code to apply for CLE credit.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

MP3 Download

  • Arizona CLE 1.5
     
  • CA MCLE 1.5
     
  • CT CLE 1.5
     
  • HI CLE 1.5
     
  • IL CLE 1.5
     
  • ME CLE 1.5
     
  • MT CLE 1.5
     
  • NJ CLE 1.8
     
  • NV CLE 1.5
     
  • VT CLE 1.5
     
  • WA CLE 1.5
     
  • WV MCLE 1.8
     
The CLE Code is ONLY a requirement when applying for CLE Credit in California (for participatory credit), Kansas, New Jersey or New York. Other states do not need to supply the CLE Code to apply for CLE credit.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Purchase Options

More Program Information

Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Faculty

Thomas Gustafson, PhD

Thomas Gustafson, PhD

Arnold & Porter LLP

  • Policy Advisor in Arnold & Porter’s Life Sciences and Healthcare Regulatory Practice, where he concentrates on Medicare reimbursement and related issues and on health policy generally
  • Distinguished 30-year career at the United States Department of Health and Human Services (HHS) in 1976 included more than 20 years at CMS, where he held several executive posts responsible for Medicare and Medicaid legislation, strategic planning, research and demonstrations, operations, and development and implementation of regulations
  • In 2003, Dr. Gustafson was named Deputy Director of the Center for Medicare Management (CMM), which coordinated the fee-for-service portion of the Medicare program and set payment rates for more than a million providers
  • Advised health-care providers, device and pharmaceutical manufacturers, and trade associations on a wide array of issue areas, including: physician, hospital and end-stage renal disease reimbursement systems; accountable care organizations; laboratory coverage, coding and payment; and launch and reimbursement issues for devices and pharmaceuticals
  • J.D. degree, Williams College; PhD, Yale University
Jeffrey R. Ruggiero

Jeffrey R. Ruggiero

Arnold & Porter LLP

  • Partner in the FDA and health care group at Arnold & Porter LLP in New York where he regularly counsels a variety of health care providers in corporate, transactional, regulatory, licensure, and litigation matters
  • Frequent lecturer and authority on ACOs, cited regularly in national newspapers such as The New York Times and The Wall Street Journal
  • Serves as lead counsel to several large clients on the formation, structure, and implementation of ACOs and other similar integrated systems including physician groups
  • Recognized by Law360 as Top 5 Health Law Practices in the U.S. for 2011; “2011 - 2012 Best Law Firms” for FDA and health care
  • Can be contacted at 212-715-1089 or [email protected]
Asim Varma

Asim Varma

Arnold & Porter LLP

  • Partner in the litigation and antitrust practice groups at Arnold & Porter LLP where she focuses on civil litigation and government investigations raising significant antitrust and intellectual property issues
  • Has been at the forefront of new health care antitrust policies and regulations, counseling clients on the antitrust implications of new structures and transactions, and assisting clients to anticipate imminent changes
  • Regular speaker and writer on ACOs and other related topics appearing in a wide variety of publications including Competition Law360, Global Competition Review, and Antitrust
  • “2011 - 2012 Best Law Firms” for antitrust; Chambers USA 2011 for antitrust; Chambers Global 2011 for antitrust
  • Can be contacted at 202-942-5180 or [email protected]
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

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Questions? Call 877-296-2169 to speak with a real person.

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Product ID: 389338
Published 2012, 2018
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