The Internal Revenue Service should extend its new guidance on private business use of tax-exempt bond financed facilities by Medicare accountable care organizations to ACO-type arrangements with non-Medicare payers, AHA told the agency in comments submitted today. According to the interim guidance, participation in the Medicare Shared Savings Program through an ACO in itself will not result in private business use of a tax-exempt bond financed facility if certain conditions are satisfied. “While this guidance is helpful, it is limited to ACOs that serve Medicare patients through the MSSP, and does not address the fact that an important element of the [Affordable Care Act] is to promote the development of ACO-type arrangements with non-Medicare payers,” wrote Melinda Hatton, AHA senior vice president and general counsel. “…Accordingly, we urge that the comfort provided by the Notice for qualified users participating in the MSSP through an ACO be extended to cover similar ACO-type arrangements with non-Medicare payers.”