Sec. 512. Eliminating certain civil money penalties; gainsharing study and report
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Section 1128A(b)(1) of the Social Security Act (42 U.S.C. 1320a–7a(b)(1)) is amended by inserting medically necessary after reduce or limit . The amendment made by paragraph
(1)shall apply to payments made on or after the date of the enactment of this Act. Not later than 12 months after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with the Inspector General of the Department of Health and Human Services, shall submit to Congress a report with options for amending existing fraud and abuse laws in, and regulations related to, titles XI and XVIII of the Social Security Act ( 42 U.S.C. 301 et seq. ), through exceptions, safe harbors, or other narrowly targeted provisions, to permit gainsharing arrangements that otherwise would be subject to the civil money penalties described in paragraphs
(1)and
(2)of section 1128A(b) of such Act (42 U.S.C. 1320a–7a(b)), or similar arrangements between physicians and hospitals, and that improve care while reducing waste and increasing efficiency. The report shall— consider whether such provisions should apply to ownership interests, compensation arrangements, or other relationships; describe how the recommendations address accountability, transparency, and quality, including how best to limit inducements to stint on care, discharge patients prematurely, or otherwise reduce or limit medically necessary care; and consider whether a portion of any savings generated by such arrangements (as compared to an historical benchmark or other metric specified by the Secretary to determine the impact of delivery and payment system changes under such title XVIII on expenditures made under such title) should accrue to the Medicare program under title XVIII of the Social Security Act.
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- 42 USC 1320a–7a(b)(1)
- 42 USC 1320a–7a(b)
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Sec. 512
Eliminating certain civil money penalties; gainsharing study and report
Cite42 USC 1320a–7a(b)(1)
Cite42 USC 1320a–7a(b)
Cites 3Cited by 0 across 0 sources