The Secretary of the Department of Health and Human Services has provided four waivers of federal fraud and abuse laws in connection with the Medicare Shared Savings Program. The ACO Board of Directors has made a bona fide determination that an arrangement with Quest Diagnostics as described below is reasonably related to the purpose of the Medicare Shared Savings Program, and has authorized such arrangement. The collaboration is related to the purposes of the Medicare Shared Savings Program because it promotes accountability for the quality, cost, and overall care for a Medicare population by managing and coordinating care for Medicare beneficiaries, and encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for Medicare beneficiaries. Specifically, Zia ACO is seeking ACO Participation Waiver protection for its arrangement with Quest Diagnostics to:
• Promote evidence-based medicine and patient engagement.
• Meet the requirements for reporting quality and cost measures coordinating care.
• Establish clinical and administrative systems.
• Meet the clinical integration requirements of the Medicare Shared Savings Program.
• Evaluate the health needs of the ACO’s aligned population.
• Communicate clinical knowledge and evidence-based medicine to Medicare beneficiaries.
• Develop standards for beneficiary access and communication, including beneficiary access to medical records.