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CMS-1403-FC
through changes in physician clinical or administrative
practices or actual cost savings for the hospital resulting
from the reduction of waste or changes in physician
clinical or administrative practices (73 FR 38553). To be
protected, the program must achieve one or both of these
goals without an adverse effect on, or diminution in, the
quality of hospital patient care services.
(1) Objective medical evidence and independent review
Under the proposed exception, incentive payment and
shared savings programs must be supported by objective,
independent medical evidence indicating that the applicable
cost-savings or quality performance measures would not
adversely affect patient care. We also proposed that
patient care quality measures must derive from CMS’
Specifications Manual for National Hospital Quality
Measures. Many commenters objected to this limitation;
however, the comments, for the most part, did not contain
suggestions regarding other appropriate lists of quality
measures or whether (and in what manner or under what
circumstances) we should permit parties to establish their
own quality measures for inclusion in a protected incentive
payment or shared savings program. We are seeking comments
on this issue, including [10] how we might avoid protecting
payments based on sham measures or measures that do not
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