Manatt Professional Speaks to Daily Journal on California ACO Regulations

“Health Care Providers Unsure of New Collaborative Organization”
Daily Journal 

September 13, 2011 – Manatt’s Jonah P. B. Frohlich, a managing director of Manatt Health Solutions, spoke to the Daily Journal about how modifications must be made to the California regulatory framework to facilitate formation of accountable care organizations in the state.

The article points out that though the Centers for Medicaid and Medicare Services will provide incentives for doctors and hospitals to work together in an accountable care organization, the concept of multiple healthcare providers joining teams violates numerous federal and state antitrust laws.

In order for ACOs to legally proceed, federal regulators have issued waivers from scrutiny under antitrust and antikickback laws. However, ACOs in California are at risk because no modifications have been made to the state laws that conflict with federal health reform requirements.

“There are some outstanding questions with respect to how ACOs might be licensed and regulated,” said Frohlich.

A recent Manatt Health Solutions assessment prepared for the California HealthCare Foundation concluded that regulatory changes would be necessary to ensure that state laws don’t make ACOs impossible in California.

“By and large ACOs can be established in California under the existing regulatory framework, but with some minor modifications to the regulations,” Frohlich said.