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CMS-1403-FC
physicians were not participating in the incentive payment
or shared savings program under which the payment is made.
We reiterate our concern that payments made to physician
organizations with nonparticipating physicians could be
used to reward such nonparticipating physicians for their
referrals. Many commenters objected to the strict
limitations on the parties to whom a hospital may make a
payment under an incentive payment or shared savings
program. Commenters generally urged greater flexibility in
the distribution of payments. We are seeking here specific
information regarding [28] conditions that could be imposed
to ensure no risk of program or patient abuse including,
for example, conditions on the use and distribution of
payments made to physician organizations on behalf of
participating physicians.
(3) Costs savings for shared savings programs
With respect to shared savings programs, we proposed
various methods and sought comments on other methods for
limiting or capping the total amount of cost savings
available under the program. We proposed a flat,
50 percent limit on the amount of cost savings eligible for
sharing with participating physicians, and also proposed
requiring rebasing of the baseline statistics against which
reduction in waste and cost savings would be measured. In
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