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CMS-1403-FC
and “quality maintenance” and, if so, how we should define
those terms in relation to each other, whether an exception
should protect payments for both, and whether they should
be valued differently (based on the supposition that
improving quality may require more effort than maintaining
it); and [44] how we can prevent protecting payments for
programs that are not meeting their quality goals or for
measures that, when achieved, result in a diminution of
patient care quality.
iv. Structure of the Arrangement between the Hospital
Sponsoring the Program and the Physicians Participating in
the Program
(1) Documentation
In the CY 2009 PFS proposed rule, we included in the
proposed exception for incentive payment and shared savings
programs a requirement that the sponsoring hospital
maintain certain documentation regarding the program that
must be made available to the Secretary upon request. Many
commenters supported this requirement, while others stated
that it presented an undue administrative burden. We are
seeking comments regarding [45] possible ways to reduce the
administrative burden and cost for hospitals that would not
hinder the government’s ability to enforce the physician
self-referral law and ensure compliance with a final
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