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CMS-1403-FC
relatively narrow. We acknowledged that it was unlikely to
cover as many arrangements as interested stakeholders would
like, and sought comments on ways that we might expand the
proposed exception without a risk of program or patient
abuse.
We received approximately 55 timely public comment
letters regarding the proposed exception for incentive
payment and shared savings programs. The majority of
commenters supported the establishment of the following:
(1) an exception for incentive payment and shared savings
programs; or (2) two exceptions--one for incentive payment
programs and one for shared savings programs. However,
most of these commenters urged us to finalize such an
exception or exceptions only if substantial modifications
were made to the conditions proposed. We also received a
number of comment letters urging us not to finalize an
exception for incentive payment and shared savings
programs, some of which asserted that we lack statutory
authority to do so and contended that any such exception
necessarily would pose a risk of program or patient abuse.
As we stated in the CY 2009 PFS proposed rule
(73 FR 38548):
In reviewing various programs and industry
suggestions, we have been struck by the
considerable variety and complexity of existing
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