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 (www.kslaw.com):

http://www.kslaw.com/portal/server.pt?space=KSPublicRedirect&control=KSPublicRedirect&PublicationId=1906#HH1

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.