Corporate Compliance

CMS releases display copy of CY 2009 MPFS, seeks comments on Stark exception

Compliance Monitor, November 5, 2008

On October 30, CMS released a display copy of the Medicare Physician Fee Schedule (MPFS) final rule for calendar year 2009 (CY 2009). The final rule will be published in the November 19 issue of the Federal Register.
 
According to the document, CMS received 55 public comment letters in reference to the proposed Stark Law exception for incentive payment and shared savings programs. CMS said the majority of commenters supported separate exceptions for incentive payment and shared savings programs, but wanted CMS to make modifications before each became part of the final rule.
 
Despite receiving several constructive comments on arrangements affected by the potential exception, CMS decided to reopen the comment period for 90 days in hopes commenters will agree on an exception broad enough to apply to as many parties as possible, but still prevent abuse.
 
CMS is seeking comments that:
  • Define the terms “incentive payment program” and “shared savings program”
  • Determine whether the terminology “incentive payment” and “shared savings” programs are appropriate or whether different terminology would better describe the range of nonabusive programs CMS intends to cover under the proposed exception(s)
  • Identify with specificity which conditions should be made applicable to incentive payment programs (and why)
  • Identify which conditions need not or should not be made applicable to incentive payment programs (and why)
  • Indicate why it would not be necessary to impose on both types of programs the same safeguards against program or patient abuse
  • Determine whether a program involving cost savings measures that also improve quality should be treated as an incentive payment or shared savings program
To read the display copy of the MPFS, click here
 
For more information on Stark Law updates, join us December 11 for the “Stark Law Update: Analysis of Recent Changes to Phase III” audio conference. Click here to register for the event.

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