(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 39
Medicare FFS beneficiaries and have established a mechanism for shared governance that
provides all ACO participants with an appropriate proportionate control over the ACO's
decision making process,
• ACO participant means a Medicare-enrolled provider of services and/or a
supplier, (as discussed in section II.B. of this proposed rule, as identified by a TIN).
• ACO provider/supplier means a provider of services and/or a supplier (as
discussed in section II.B. of this proposed rule) that bills for items and services it
furnishes to Medicare beneficiaries under a Medicare billing number assigned to the TIN
of an ACO participant in accordance with applicable Medicare rules and regulations.
B. Eligibility and Governance
1. Eligible Entities
Section 1899(b) of the Act establishes eligibility requirements for ACOs
participating in the Shared Savings Program. Section 1899(b)(1) of the Act allows
several designated groups of providers of services and suppliers to participate as an ACO
under this program, "as determined appropriate by the Secretary," and under the
condition that they have "established a mechanism for shared governance." The statute
lists the following groups of providers of services and suppliers as eligible to participate
as an ACO:
• ACO professionals in group practice arrangements.
• Networks of individual practices of ACO professionals.
• Partnerships or joint venture arrangements between hospitals and ACO
professionals.
• Hospitals employing ACO professionals.