CMS & OIG Finalize ACO Fraud & Abuse Waivers

On October 29, 2015, the Centers for Medicare & Medicaid Services (CMS) and the Office of the Inspector General (OIG) of the Department of Health and Human Services finalized rules for five fraud and abuse law waivers in connection with the Medicare Shared Savings Program (MSSP). The waivers are for Accountable Care Organizations (ACOs) and grant exemptions to provisions of the physician self-referral law, the Federal anti-kickback statute, and provisions of the civil monetary penalties law regarding beneficiary inducements.

The five waivers are: the ACO Pre-Participation Waiver; the ACO Participation Waiver; the Shared Savings Distributions Waiver; the . . .