Two gainsharing arrangements between a hospital and physician groups have gotten an OK in advisory opinions from the HHS Inspector General's office. The ruling assures the applicant(s) that they'd be unlikely to face a civil monetary penalty or accusations of violating the anti-kickback statue for making these arrangements. While it's not clear how widespread the influence of these decisions will be--they appear to be advice to one hospital, though the name has been redacted from the documents--they still shed at least some light on an issue which continues to trouble hospitals.
In its advisory opinion, the HHS IG ruled that plans for sharing cost savings with cardiologists and anesthesiologists at the unnamed hospital aren't likely to harm patients or encourage kickbacks, because the hospital had provided well-detailed rules which were tied to measurable clinical measures. For example, the system allows anesthesiologists to use a cheaper type of catheter in 90 percent of cases, but won't allow them to gain when the number of uses goes above 90 percent.
To learn more about the advisory opinion:
- read this Modern Healthcare item
- read the IG opinions
CMS seeks rural hospitals for gainsharing program. Report
HHS gives health centers an anti-kickback break. Report