(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 319
information. If the ACO fails to report by the requested deadline and does not provide a
reasonable explanation for delayed reporting, we would immediately terminate the ACO
for failing to report quality measures. We further propose that ACOs that exhibit a
pattern of inaccurate or incomplete reporting or fail to make timely corrections following
notice to resubmit may be terminated from the program. We note that since meeting the
quality standard is a condition for sharing in savings, the ACO would be disqualified
from sharing in savings in each year in which it underperforms.
3. Terminating an ACO Agreement
There are a number of important program requirements that ACOs must satisfy in
order to be eligible to participate in the Shared Savings Program. As a result, in addition
to the statutory provisions at section 1899(d)(3) and (d)(4) of the Act regarding
termination for avoidance of at-risk beneficiaries and for failure to meet the quality
standards, we believe the agreement with an ACO should be contingent upon that ACO
continuing to meet the requirements for eligibility to participate in the Shared Savings
Program. Accordingly, we propose that an ACO's failure to continue to meet the
eligibility requirements for participation in the Shared Savings Program should also result
in an ACO's termination from the Shared Savings Program. As described in section II.F.
of this proposed rule, termination of an ACO from the Shared Savings Program by us or
at the ACOs request for any reason will result in loss of the mandatory 25 percent
withhold of shared savings.
Therefore, we are proposing that based upon monitoring and assessing ACO
operations (including ACO participants and ACO providers/suppliers), we may terminate