ACO Rule Finalizes Fraud and Abuse Waivers

November 4, 2015 | Strategic Insights for Health System


​A final rule from the Centers for Medicare and Medicaid Services (CMS) finalizes most of the previously existing waivers to a variety of fraud and abuse provisions for accountable care organizations (ACOs). Among the finalized waivers are those related to physician self-referral law, the anti-kickback statute, and the civil monetary penalties law provision relating to certain beneficiary inducements. The waivers are intended to ensure that ACOs enrolled in the Medicare Shared Savings Program are not unduly impeded in taking advantage of their shared resources while still ensuring that adequate fraud and abuse protections remain in place.

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