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Health Care Providers › Gainsharing

Baker Donelson

Maryland All-Payer Model's Progression to Total Cost of Care: Alignment Strategies for Stakeholders in New Cost Paradigm

Baker Donelson on

The State of Maryland is unique in its historical experimentation with rate setting and global budgets for hospitals, and that experimentation continues with the Maryland Total Cost of Care Model (TCOC). Beginning January...more

Tucker Arensberg, P.C.

OIG Gainsharing Opinion Facilitates P4P

Tucker Arensberg, P.C. on

Although it has been almost a decade since the OIG has issued a gainsharing opinion, OIG Advisory Opinion No. 17-09 confirms the federal government’s support of the pay for performance concept. OIG 17-09 is the first...more

Polsinelli

Gainsharing Guidance: Clarification on Cost-Savings Arrangements Between Hospitals and Physicians

Polsinelli on

The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) recently posted its first advisory opinion interpreting a gainsharing arrangement – that is, a financial relationship under which...more

Dorsey & Whitney LLP

OIG Issues Favorable Advisory Opinion Addressing Gainsharing CMP Arrangement

Dorsey & Whitney LLP on

On January 5, 2018, the Office of the Inspector General of the United States Department of Health and Human Services (“OIG”) released a favorable Advisory Opinion 17-09 that addresses Section 1128A(b)(1) of the Social...more

Proskauer Rose LLP

New Medicare Law Advances Gainsharing

Proskauer Rose LLP on

On April 16, 2015, President Obama signed into law H.R.2, the Medicare Access and CHIP Reauthorization Act of 2015 (the "Act"), which provides for sweeping changes to how Medicare pays doctors. Specifically, the Act seeks to...more

K&L Gates LLP

SGR Law Brings Changes to CMP Prohibition on Gainsharing

K&L Gates LLP on

On April 16, President Barack Obama signed into law the “Medicare Access and CHIP Reauthorization Act of 2015,” ending a perennial struggle over the Medicare reimbursement formula for physicians. Although the law is most...more

Morgan Lewis

OIG Proposes Rules on Free Transportation, Hospital Gainsharing, and Other Access to Care Arrangements

Morgan Lewis on

The proposed rule to give providers more protections to promote beneficiary access to care solicits significant industry input. On October 2, the Department of Health and Human Services (HHS) Office of Inspector...more

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