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AHA Fears Tightening of Antitrust Restrictions Regarding ACOs
On January 3, the AHA noted in a response to a public request for comment that it was disappointed (PDF) in a little-noticed announcement from the Centers for Medicare & Medicaid Services (CMS) that it planned to tighten some ACO fraud-and-abuse waivers by narrowing legal definitions after two years of experience with the program.
Read the full story at: http://tinyurl.com/8xxdqw9
Source: Modern Healthcare
The AHA urged CMS to declare that it would only make material changes to the rules after a public notice-and-comment period. “ACOs should not be at risk for changes to the rules through obscure or little noticed issuances,” the AHA letter said.
Although observers roundly praised federal officials for loosening the antitrust and abuse rules on accountable care organizations (ACOs), the American Hospital Association (AHA) is protesting what it says are efforts by regulators to move back toward stricter enforcement over time.
ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
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