Proposed 2025 PFS Could Mean Broader Solution To ACO Anomalous Billing Issue

The proposed 2025 Medicare Physician Fee Schedule could lead to a solution for when accountable care organizations are forced to pay for anomalous spending that is not done at the behest of the ACO itself. The fee schedule provision builds on a narrower rule proposed by CMS last month that would hold harmless ACOs whose spending on catheters skyrocketed last year due to an alleged fraudulent billing scheme. The proposed fee schedule rule outlines a broader approach to “account for...