11555 Heron Bay Blvd, Suite 200
Coral Spring FL 33076

Phone : 954.228.7475

PUBLIC REPORTING

ACO Name and Location

Sovereign ACO, LLC
11555 Heron Bay Blvd
Suite 200
Coral Springs FL, 33076

ACO Primary Contact

Primary Contact Name

Lucious Coleman, Jr

Primary Contact Number

954-990-7045

Primary Contact Email

lucious@sovereignaco.com

Organizational Information

ACO participants:


ACO Participants

ACO Participant in Joint Venture ?

Ace Medical, LLC

N

Anil George, MD, P.A.

N

Center for Health & Sports Medicine

N

Comprehensive Health Center, LLC

N

Delmar Primary Care Associates

N

eMed Urgent and Primary Care PA

N

Kansas Medical Associates, PA

N

Lopez Internal Medicine Associates, Inc

N

Michael M Bahrami, MD PA

N

Perry General & Internal Medicine of Northeast Florida, Inc.

N

Ricardo Budjak,M.D., P.A.

N

Ridge Medical Associates, L.L.C.

N

Rowan Primary Care

N

Taylor Internal Medicine of Selma, P.C.

N

Titus A Taube, MD

N

ACO Participants in joint ventures
between ACO professionals and hospitals

ACO participants are not in joint ventures with other ACO professionals and/or hospitals.

Medicare Shared Savings Program

Medicare Shared Savings Program

2018 Governing Body Template

ACO ID: A3782
ACO Legal Business Name: Sovereign ACO, LLC

 

Member Last Name Member First Name Member Title / Position Member's Voting Power Membership Type: ACO Participant TIN Legal Business Name /If Applicable
1 George Anil Voting Member* 8.44% ACO Participant Representative Anil George, MD, P.A.
2 Osborn Ross Voting Member* 8.44% ACO Participant Representativ Center for Health & Sports Medicine
3 Moise Rudolph Voting Member* 8.44% ACO Participant Representative Comprehensive Health Center, LLC
4 Perry Nathan Voting Member* 8.44% ACO Participant Representative Perry General & Internal Medicine of Northeast Florida, Inc.
5 Lopez Albert Voting Member* 8.44% ACO Participant Representative Lopez Internal Medicine Associates, Inc
6 Budjak Ricardo Voting Member* 8.44% ACO Participant Representative Ricardo Budjak,M.D., P.A.
7 Bahrami Michael Voting Member* 8.44% ACO Participant Representative Michael M Bahrami, MD PA
8 Willams Dannie Voting Member* 8.44% ACO Participant Representative Delmar Primary Care Associates
9 Taube Titus Voting Member* 8.44 ACO Participant Representative Titus A Taube, MD
10 McDonlald Luevern Voting Member* 2.00% Medicare Beneficiary Medicare Beneficiary
11 Pope Dwayne Voting Member* 11.00% Other: LifeBrite N/A
12 Coleman Lucious Chairman of Board/Voting Member** 11.00% Other: CEO N/A

*All 12 members of the Board of Managing Members are voting members. The ACO's governing body will provide oversight and strategic direction, holding management accountable for meeting the ACO's goals. That oversight includes not only care delivery, but also processes to promote evidence-based medicine, patient engagement, reporting on quality and cost, care coordination, distribution of shared savings, establishing clinical and administrative systems, among other functions. The Board of Managing Members will meet as often as monthly. At all meetings of the Board Of Managing Members, the participation of fity One percent (51%) Managing Members will constitute a quorum for the transaction of business. Each Managing Member will exercise, in person or by proxy one vote on each issue before the Board Of Managing Members. A proxy may only be granted by a Managing Member to another Managing Member. If a quorum will not be present at any meeting of the Board Of Managing Members, the Managing Members present may adjourn the meeting from time to time and to another place without notice other than announcement at the meeting, until a quorum will be present.

**Chairman of The Board Responsibilities - A majority of the Board will elect each new board membersa chairman (the “Chairman”), provided that after the first election the then existing Chairman’s vote will not be utilized to determine a majority of the Board Of Managing Members and the majority will be reduced by one unless there is a deadlock in the vote of the Board Of Managing Members, in which case the Chairman will vote to break such deadlock. The Chairman will be responsible for conducting all meetings of the Board Of Managing Members. He or she will serve in this capacity for a term of one year (other than the first Chairman who will serve only to the first meeting of the next ensuing Fiscal Year). After the election of the first Chairman, the Board of Managing Members will elect a Chairman at its first meeting of each Fiscal Year. A Chairman may be reelected an unlimited amount of times.

Key ACO clinical and administrative leadership:

Dr. Rudolph Moise

Medical Director

Lucious Coleman, Jr

ACO Executive

Lucious Coleman, Jr

Compliance Official

Dr. Alberto Lopez

Quality Assurance/Improvement Officer

Payment Rule Waivers


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