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CMS-1403-FC
arrangements, and the likelihood of continued
future innovation in the structure and method of
these programs. This variety and complexity make
it difficult to craft a “one-size-fits-all” set
of conditions that are sufficiently “bright line”
to facilitate compliance and enforceability, yet
sufficiently flexible to permit innovation
without undue risk of program or patient abuse.
Our goal in establishing an exception or exceptions for
incentive payment and shared savings programs is “to
promulgate an exception that is as broad as possible” yet
consistent with the statutory requirement that any
arrangement excepted under an exception issued using our
authority in section 1877(b)(4) of the Act pose no risk of
program or patient abuse (73 FR 38548). Although we
received thoughtful and instructive comments, we did not
receive through the initial public comment process
sufficient information or agreement among commenters
regarding possible modifications to the proposal to allow
us to finalize an exception that expands the proposed
exception in any meaningful way. Therefore, we are
reopening the public comment period to obtain the specific
information described below. We believe that, if
ultimately provided through the extended public comment
process, the additional information we are requesting will
assist us in finalizing an exception or exceptions for
incentive payment and shared savings programs. The comment
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