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Recent Release of the Proposed Accountable Care Organization Regulations and Related CMS, OIG, FTC, DOJ and IRS Content: Piecing the Puzzle Together

Event | 04.21.11, 12:00 AM UTC - 12:00 AM UTC

Click here for the presentation slides [PDF]

The recent release of the proposed Accountable Care Organization regulations by the Centers for Medicare & Medicaid Services along with the release of related content by CMS, the Health and Human Service Office of Inspector General, the Federal Trade Commission, the Department of Justice, and the Internal Revenue Service provide long-awaited details of the Medicare Shared Savings Program and ACO landscape. But still, many questions remain unanswered, and the recent releases raise new uncertainties.

Please join us on April 21 for a webinar discussing these important developments and their implications.

In this concise and focused presentation, Crowell & Moring panelists will discuss:

  • Highlights from the proposed regulations, including acceptance into the Medicare Shared Savings Program, the two available ACO risk models, quality and financial performance measures and methodologies, patient notification and choice, and more.
  • The new antitrust "safety zone," mandatory antitrust review for ACOs exceeding market share thresholds, and how ACOs will be assessed and reviewed by the DOJ and FTC according to their proposed statement of antitrust enforcement policy.
  • The impact of CMS' and OIG's proposed waivers of the physician self-referral law, the anti-kickback statute, and certain provisions of the civil monetary penalty law on providers participating in the Medicare Shared Savings Program.
  • Key tax questions posed by the IRS.

Who should participate:
In-House Counsel
Executive Officers
Compliance Officers

Crowell & Moring Panelists:
Art Lerner
Christine Rinn
Michael W. Paddock
Kathleen Stratton

Date: Thursday, April 21, 2011
Time: 2:00 - 3:30 pm EDT

Shortly after registration, you will receive instructions for
logging on and dialing into this webinar.

There is no charge for this webinar

Insights

Event | 02.20.25

Has the Buss Stopped? Recoupment Today

Has the Buss Stopped? Recoupment Today: In 1997, the California Supreme Court decided Buss v. Superior Court. In Buss, the court concluded that a liability insurer that defended a mixed action could seek reimbursement from the insured for the defense costs associated with the claims that were not even potentially covered. Since then, numerous courts have held that insurers are entitled to recoup their defense costs associated with uncovered claims or causes of action. On the other hand, a significant number of courts have rejected insurers’ right to recoupment, at least in the absence of a policy provision granting the insurer that right. Some commentators have even suggested that the current judicial trend might be away from permitting insurers to recoup their defense costs. Is that correct? Has the Buss stopped? This panel of coverage experts will analyze insurers’ claimed right to recoupment today, and offer their perspectives on what the law on recoupment should perhaps be and might be in the future.