H.R. 4773: ACO Assignment Improvement Act of 2025

This legislation, known as the ACO Assignment Improvement Act of 2025, aims to modify existing regulations within the Medicare system, particularly focusing on how beneficiaries are assigned to Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP). The primary changes proposed in the bill are as follows:

Modification of Beneficiary Assignment

The bill seeks to amend the Social Security Act to enhance and clarify the process of beneficiary assignment to ACOs. This includes:

• Altering current language to incorporate a provision that explicitly addresses primary care services delivered by ACO professionals.
• Specifying that for performance years starting on or after January 1, 2027, ACOs will have an additional factor to consider when assigning Medicare beneficiaries.

Impact on Primary Care Services

The new provision would ensure that primary care services, when provided by certain qualified ACO professionals, are taken into account during the assignment process. This change is intended to potentially streamline how beneficiaries are assigned based on their primary care experiences and needs.

Technological and Administrative Changes

To facilitate these changes, there may be requirements for improved data sharing and adjustments in administrative processes within the Medicare framework. This could involve:

• Developing IT systems that better track and report primary care services provided to beneficiaries.
• Implementing training and updates for Medicare providers on the new assignment criteria.

Goals of the Legislation

The overall goal of the ACO Assignment Improvement Act of 2025 is to improve the effectiveness and responsiveness of Medicare ACOs by ensuring that beneficiary assignments are more reflective of their primary care needs. This aligns with a broader initiative to enhance care coordination and outcomes for seniors and individuals with disabilities who rely on Medicare.

Relevant Companies

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