Accountable Care Organizations (ACO), Clinically Integrated Networks (CIN), Physician Hospital Organizations (PHO), and Independent Physician Associations (IPA)

iStock_000016083585MediumAccountable care organizations are groups of health care providers and health care suppliers that come together to improve the quality and efficiency of medical care provided to a certain portion of the population.  ACOs typically participate in the shared savings programs of various health care payors (e.g., Medicare, Medicaid and private payors).  Although the concept of ACOs is not new, ACOs gained significant popularity and attention with the passage of the Federal Affordable Care Act. In furtherance of the underlying objectives of health care reform, ACOs have been adopted as a means for payors to reimburse health care providers for value (i.e. the quality and efficiency) of care provided as opposed to the volume of care provided.  

ACOs face unique legal challenges as they bring providers together in ways that push the boundaries of numerous laws, including the Federal Stark, anti-kickback, anti-trust, patient privacy and other Federal and state laws. In addition to accepting a degree of financial risk, ACOs are often forced to operate with a certain degree of uncertainly from a legal perspective. This is why hiring the best Accountable Care Organization lawyers is crucial for navigating complex legal matters.

The attorneys at The Health Law Partners, P.C. have the experience and substantive expertise to provide ACOs with solid and practical advice for addressing a complicated web of regulation. Our team of Accountable Care Organization lawyers have worked with groups across the country to structure themselves from a corporate and governance perspective, to complete applications for the Medicare Shared Savings Program, to implement compliance plans and review their relationships to ensure consistency with applicable laws.

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