License to Chill: ACO Data Exchange in a World Without Safety Zones
This Bulletin is brought to you by AHLA’s Payers, Plans, and Managed Care Practice Group.
- March 21, 2023
- Susan Feigin Harris , Norton Rose Fulbright US LLP
- Jeff Wurzburg , Norton Rose Fulbright US LLP
- Hayley White , Norton Rose Fulbright US LLP
Managed care entities participating in ACOs are now left with new uncertainty as to whether they are exposed to increased antitrust scrutiny as they operate under previously acceptable information sharing practices.
On February 2, 2023, the U.S. Department of Justice (DOJ) withdrew a 2011 policy, initially created in response to the enactment of the Affordable Care Act (ACA), that provided an antitrust safety zone for Accountable Care Organizations (ACOs). This development will necessarily require managed care entities to rethink the manner in which they participate, and share data, between and among ACOs. Managed care has played a particularly important role in the transition to reimbursement based on value as well as the expansion of ACOs well beyond those sanctioned under the Medicare program.
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