Hospital Gainsharing Programs—Ten Years of Guidance

Over the last ten years, measuring from the date the Department of Health and Human Services Office of Inspector General (OIG) first addressed the issue of gainsharing arrangements in a Special Advisory Bulletin issued July 8, 1999, the OIG has offered analysis of several proposed gainsharing arrangements. Although the OIG advisory opinions cannot protect other hospitals structuring shared savings programs with physicians, most opinions offer guidance on necessary safeguards to avoid sanction under the Civil Monetary Penalty Law and Anti-Kickback Statute. The opinions provide no protection under the Stark rule; however, there has been no Stark enforcement against the gainsharing programs approved by the OIG.

As a follow up to my prior related blog post, this is an excellent summary by the law firm of King & Spalding (

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