OIG Approves New Gainsharing Plan; AdvaMed Critical
BY LAUREN UZDIENSKI, NOVEMBER 28, 2006
Earlier this month, the Office of the Inspector General (OIG) issued a new opinion over gainsharing. The cardiologist group who submitted the request received a favorable response, with the OIG determining that though the arrangement may violate the Social Seucrity Act and the anti-kickback statute, the OIG will not impose sanctions.
The physicians' plan will provide them with a percentage of the cost savings derived from reduction of waste and use of specific supplies during procedures. Gainsharing plans are one way for physicians to pursue additional income, one that is encouraged by CMS. However, organizations such as the MDMA oppose gainsharing, saying the arragements "negatively affect patient care, stifle medical device innovation and may ultimately result in higher long-term costs to the health care system."
AdvaMed is in this camp as well, and President and CEO Steve Ubl has spoken out in response to the OIG's recent opinion. In a statement released last week, Ubl called for a suspension of further gainsharing approvals, highlighting potential compromises in patient care (namely, the creation of "perverse incentives") and a lack of transparency: the OIG can't release details of the arrangement, which prevents an independent assessment of quality of care. With the acceptance of arrangements like these, Ubl warns that a physician's motives may cloud clinical judgment, and a range of products and manufacturers may be shut out of operating rooms. These limitations could threaten patient safety, a troubling notion regardless of whether gainsharing becomes more popular among physicians.
For more information, please see previous posts, including a guest blog from Joane Goodroe, and our report on Gainsharing.
