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Matthew J. Murer
Practice Area Chair
Colleen M. Faddick
Practice Area Vice-Chair
Bruce A. Johnson
Practice Area Vice-Chair
Alan K. Parver
Practice Area Vice-Chair
Janice A. Anderson
Douglas K. Anning
Jane E. Arnold
Jack M. Beal
Cynthia E. Berry
Mary Beth Blake
Gerald W. Brenneman
Teresa A. Brooks
Jared O. Brooner
Anika D. Clifton
Lawrence C. Conn
Anne M. Cooper
Lauren P. DeSantis-Then
S. Jay Dobbs
Thomas M. Donohoe
Cavan K. Doyle
Meredith A. Duncan
Erin Fleming Dunlap
Fredric J. Entin
Jennifer L. Evans
T. Jeffrey Fitzgerald
Michael T. Flood
Kara M. Friedman
Rebecca L. Frigy
Asher D. Funk
Randy S. Gerber
Mark H. Goran
Linas J. Grikis
Lauren Z. Groebe
Brett B. Heger
Jonathan K. Henderson
Margaret H. Hillman
Jay M. Howard
Cullin B. Hughes
Sara V. Iams
George Jackson, III
Lindsay R. Kessler
Joan B. Killgore
Anne L. Kleindienst
Chad K. Knight
Sarah R. Kocher
Dana M. Lach
Jason T. Lundy
Ryan M. McAteer
Jane K. McCahill
Ann C. McCullough
Ryan J. Mize
Aileen T. Murphy
Hannah L. Neshek
Gerald A. Niederman
Edward F. Novak
Thomas P. O'Donnell
Aaron E. Perry
Mitchell D. Raup
Daniel S. Reinberg
Donna J. Ruzicka
Charles P. Sheets
Kathryn M. Stalmack
Leah Mendelsohn Stone
Chad C. Stout
Steven K. Stranne
William E. Swart
Tennille A. Syrstad
Emily C. Tremmel
Andrew B. Turk
Joseph T. Van Leer
Andrew J. Voss
Joshua M. Weaver
Emily Wey
Mark R. Woodbury
Janet E. Zeigler
Additional Health Care
Professionals
Julius W. Hobson, Jr.
Harry Sporidis
To learn more about our
Health Care practice,
click here.
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January 2013 |
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A Polsinelli Shughart Update: |
OIG Issues Advisory Opinion on Co-Management Incentive Compensation Arrangement |
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On January 7, 2012, the OIG posted Advisory Opinion No. 12-22 to address a co-management arrangement between a hospital and physicians that is designed to align incentives by offering compensation based on quality, service, and cost saving measures. The OIG concluded that the arrangement could constitute improper payment to either reduce or limit services or induce referrals under the CMP Law, warranting civil monetary penalties or Anti-Kickback Statute sanctions; however, the OIG would not impose any sanctions due to several safeguards in the arrangement.
Co-management arrangements are frequently used to align and reward physicians for assisting the hospital in managing a service line and often include incentive compensation to improve the service line's quality and efficiency. Although co-management arrangements are widely used in the industry, and the OIG has previously opined on numerous gainsharing arrangements, Advisory Opinion No. 12-22 marks the first time that the OIG evaluated a co-management arrangement.
The Advisory Opinion provides hospitals and physicians with helpful guidance as to the OIG's view of co-management arrangements, although only the requestor can rely upon it for protection. Of importance to its analysis, the OIG emphasized safeguards that have long been recognized as important to protect any type of quality or efficiency payment made by hospitals to physicians. These safeguards include (i) independent monitoring to ensure that no inappropriate changes occur to quality or referral patterns and that no inappropriate reduction in care occurs, (ii) payments that are deemed fair market value based on the services rendered by the physicians, (iii) transparency in the metrics chosen, (iv) metrics that reward improvement and not just maintenance of previous levels of achievement, and (v) continued access by the physicians to the full panoply of treatment options, reasonable limitation in the duration of the arrangement, among others. Click here for more detailed information about Advisory Opinion No. 12-22.
For More Information
For any questions, please contact:
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