By David R. Garcia

The Department of Justice and Federal Trade Commission have recently proposed new guidelines delineating a three-tiered structure of antitrust scrutiny for accountable care organizations — the new healthcare delivery model mandated by the 2010 Patient Protection and Affordable Care Act — based on certain calculations of market shares of independent provider ACO participants. The proposed statement, intended to operate in conjunction with the Department of Health and Human Services’ Centers for Medicare and Medicaid Services’ proposed regulations on the same subject — is intended to ensure that providers have the antitrust clarity and guidance necessary to form pro-competitive ACOs, while also ensuring against the unintended effect of reducing competition. The statement will have significant ramifications for all providers interested in ACO formation. For a more detailed explanation of the proposed statement, please see the attached article.

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Authored By:

David R. Garcia
(310) 228-3747
dgarcia@sheppardmullin.com

Reprinted with permission from the April 18, 2011 edition of The Recorder. © Copyright 2011. ALM Media Properties, LLC. All rights reserved. Further duplication without permission is prohibited. For information, call 415.490.1050 or aholian@alm.com.