Proposed Stark Exception Covers Pay-for-Performance and Gainsharing Programs
July 10, 2008
The current Medicare physician self-referral law (the "Stark Law") is potentially implicated by any payment made to a physician under pay-for-performance ("P4P"), gainsharing and other similar quality improvement and cost saving incentive programs. Over the last several years, many hospitals and third-party payors, including Medicare, have implemented or are exploring ways to implement such programs. The Centers for Medicare and Medicaid Services (CMS) recognizes that P4P and gainsharing programs can be beneficial to providers, payors and beneficiaries. In order to encourage the development of performance improvement and cost savings programs, the proposed 2009 Medicare Physician Fee Schedule (PFS) regulation, 73 FR 38502, creates an exception to the Stark Law specifically tailored to these programs. This White Paper discusses the proposed regulation and its implications in detail.
Please click here to view the entire White Paper in Adobe PDF format.
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