Affordable Care Act and Accountable Care Organizations (ACOs)

The Patient Protection and Affordable Care Act of 2010 (PPACA) added additional complexity to the already highly-regulated healthcare industry. New initiatives have focused on rewarding quality and efficiency and controlling costs, as opposed to the former fee-for-service model. Our healthcare lawyers are well-versed in the recent healthcare laws and can counsel clients on how best to comply and maximize their opportunities in this new environment.

We have advised clients in the formation and structuring of ACOs, as part of the Medicare Shared Savings Program. These arrangements require considerable experience to coordinate the requirements of the various state and federal laws and regulations. In particular, we have experience with the CMS application process, ACO waivers, tax and antitrust issues, nonprofit health organizations, and arrangements with ancillary service providers. Our lawyers can help clients in ACO formation and structure, answer regulatory and compliance questions, and provide continuing legal advice and support.

Most recently, we represented an ACO having more than 300 independent physicians and an investor entity in the formation and successful CMS application and certification process. As part of this entity, we formed a Nonprofit Healthcare Organization (also known as a 5.01(a)), which was certified by the state medical board. ACOs and the entities and arrangements required to support them provide unique legal and compliance challenges, however, our lawyers at Haynes and Boone can help you overcome the obstacles to create successful ventures.

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