H.R. 6101 · 114th Congress
ACO Improvement Act of 2016
- Stage
- In committee
- Sponsor
- Diane Black
- Introduced
- 2016-09-21
- Latest action
- 2016-09-28 · Referred to the Subcommittee on Health.
Summary
ACO Improvement Act of 2016
This bill amends title XVIII (Medicare) of the Social Security Act to allow an accountable care organization (ACO) to: (1) reduce or eliminate certain cost-sharing for primary care services provided within the ACO's network; (2) develop incentives to encourage patient engagement; (3) elect prospective assignment of Medicare fee-for-service beneficiaries; and (4) if specified requirements are met, distribute internal cost savings.
The Centers for Medicare & Medicaid Services (CMS) shall waive specified regulatory requirements for ACOs that have elected to share in both savings and losses under a "two-sided risk model."
In addition, the bill: (1) requires CMS to waive, with respect to certain ACOs, specified limitations regarding telehealth services; (2) allows certain ACOs to depart slightly from specified minimum enrollment requirements; (3) requires CMS to establish a demonstration project for allowing growth of certain prospective risk scores; (4) and allows CMS to make permanent certain ACO-related pilot programs that have been successful.