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CMS-1403-FC
changes in referral patterns due to financial incentives
available to physicians participating in an incentive
payment or shared savings program (73 FR 38555). Where
changes in the volume of Federal health care patients or
services occur because of financial incentives, a risk of
abuse exists. We are soliciting comments that [26]
specifically address how to account for legitimate
fluctuations in the volume of Federal health care patient
procedures or services and consider the potential that
volume increases can indicate altered referral patterns
when a physician is participating in an incentive payment
or shared savings program. In addition, we are seeking
comments regarding [27] possible ways to ensure against
increases in total Medicare expenditures for patients for
whom services are provided under an incentive payment or
shared savings program.
We proposed to require hospitals to make payments
directly to participating physicians or to a “qualified
physician organization,” which we proposed to define as a
physician organization composed entirely of physicians
participating in the incentive payment or shared savings
program (73 FR 38553). We sought comments regarding
possible expansion of this condition to allow payments to a
physician organization even if all of its affiliated
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