Hospitals Urge Change in CMS and OIG ‘Gainsharing’ Policies

In a 13-page letter to CMS, representatives of the nation’s largest hospital associations pushed the agency to expand its limitations on physician-hospital collaborations.

Advertisement

The American Hospital Association, Federation of American Hospitals and Association of American Medical Colleges are supporting revisions to a new exception to the physician self-referral law, also known as the Stark law, for incentive payment and shared-savings programs.

Shared savings programs, known as ‘gainsharing,’ allow hospitals and physicians to work together to improve quality and patient care and share in any savings from those collaborations. The hospital groups claim the current proposed exception is too limiting, costly, burdensome and complex to make it useful to providers, saying it stifles innovation. They recommend modifying the proposed exception to reduce burdensome mandates.

Read the joint gainsharing letter (pdf).

The same groups sent a three-page letter to HHS’ Inspector General Daniel Levinson urging him to withdraw the agency’s 1999 gainsharing opinion, which they consider obsolete and a barrier limiting physician hospital collaborations.  

To read that letter, click here (pdf).

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.