Recent media reports indicate that Centers for Medicare & Medicaid Services (CMS) Administrator Donald Berwick is working to provide seed money for 100 to 300 sites to test new models of caring for patients. Health care providers, including physician groups and hospitals, around the country are vying for designation as "accountable care organizations" to participate in the program. The effort stems from a provision in the new health care law to spend $10 billion at an innovation center over the next decade to help find the best ways of improving care and reducing costs. The center is expected to attempt to switch reimbursement methodologies from "fee-for-service" to "global payments", which provide flat fees for coordinating care for populations of patients, with built-in incentives for keeping them healthy and reducing hospital stays.

About Sam Fish

Sam Fish has over 40 years of legal experience in federal and state human services laws and programs, having joined PCG in 1995 after serving as Chief Counsel, Region I, for the U.S. Department of Health and Human Services for more than 25 years. At PCG, Sam provides legal advice and counsel and has served on many projects that required legal research and interpretation and implementation of many federal and state laws. He has also participated in in-house training in new litigation areas, including Temporary Assistance for Needy Families (TANF), the Balanced Budget Act (BBA), and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). He is available for legal guidance in program areas including school-based billing, third-party liability, Olmstead implementation, and Medicare and Medicaid reimbursement. Currently, he is providing guidance and counsel in the interpretation and implementation of the new health care legislation.

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