AICPA National Healthcare Industry Conference Healthcare Hardball QuestionsNovember 17th, 2012 | Healthcare Reform | Medicare | Reasonable Comp | Regulatory Matters | Seminars & Publications
We had a question we could not answer definitively at yesterday’s Healthcare Hardball session concerning assignment of Medicare beneficiaries to an ACO when they do not have a Primary Care Physician. The answer is that if a beneficiary does not see a PCP, as defined in the regulations, CMS will then evaluate which specialist physicians the beneficiary sought primary care services from. Presumably, this would be based on CPT and ICD data. Chapter 8 of my book on Healthcare Reform with Greg Anderson is devoted to ACOs.
Someone also had a question about the excise tax on Medical Devices and here is the link to the IRS web page that contains links to the various issuances on the ACA.
The issue of tax-exempt organizations participation in the Medicare Shared Savings Program (ACOs) also came up and I said I would post the link to the IRS position on same. Importantly, the IRS has in no way waived the general rules of 501(c)(3) for participation and the anti-inurement rules still apply – unlike the waivers from Stark, AKS and anti-trust issues provided by CMS and DOJ. As I indicated in my session on Valuation and Reasonable Compensaiton for tax purposes, there is a lack of focus on income tax issues due to the prevailing obsession with Stark and the AKS.
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