CMS issues final rule on ACO significant, anomalous and highly suspect billing

The Centers for Medicare & Medicaid Services Sept. 24 issued a final rule that would carve out significant, anomalous, and highly suspect (SAHS) billing from Medicare Shared Savings Program financial calculations for calendar year 2023. The final rule is part of a larger CMS strategy to address SAHS billing activity within Accountable Care Organizations’ reconciliation. Specifically, the agency also addressed this issue in the CY 2025 physician fee schedule proposed rule. The rule's changes become effective Oct. 15.