Kathleen Sebelius said the regulations will be out in the 'next couple weeks.' | AP Photo
By DAVID NATHER & J. LESTER FEDER | 3/29/11 5:22 PM EDT
Health care lobbyists and advocates are bracing for six pages of the health care reform law to explode into a phonebook-sized federal regulation when the Department of Health and Human Services releases its long-delayed accountable care organization rule expected this week.
“What, you expected less than a thousand pages for legislation that only took a page and half?” a staffer with one of the current proto-ACOs asked.
The staffer exaggerated; the Affordable Care Act devoted about six pages, not one and a half, to the accountable care organizations — networks of hospitals and doctors that are supposed to drive down costs and improve care by sharing responsibility for patients. A senior administration official said the rule is not a thousand pages, but he declined to say how many pages it is.
How do you turn six pages of legislation into hundreds of pages of rules? You kind of have to, in order to settle all of the questions that hospitals and doctors want settled so they don’t get into trouble.
They have to know who can become an accountable care organization – a formula that could be different in different parts of the country – and how you’d know if the organization actually saved money. They’d need to know how to report what they’re doing. And they need to know how to join together without breaking the antitrust laws that are already on the books.
At one point, Centers for Medicare and Medicaid Services administrator Don Berwick had suggested the rules would be out by Jan. 15. HHS Secretary Kathleen Sebelius, who had promised that the regulations would be out by the end of March, said last week that they’d be out “in the next couple weeks.”
The silence has left room for plenty of speculation. Several industry sources have told POLITICO that they’re expecting at least 1,000 pages of regulations to emerge from the process.
One of them is John Gorman, a former official with the predecessor office to CMS who is now CEO of the Medicare/Medicaid consulting firm Gorman Health Group. He said he expects the rule to come out on Thursday, March 31—because he doesn’t think HHS will want to deal with releasing the regulation on April Fool’s Day.
UPDATE: This story has been updated to add the comment of a senior administration official that the rule will not be 1,000 pages…. but probably close!
Read more: http://www.politico.com/news/stories/0311/52170.html#ixzz1ILPuySGm
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