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CMS-1403-FC
the physician group should be required to participate in
the same measures.
v. Availability of other physician-self referral
exceptions
We note that there are many exceptions for
compensation arrangements in §411.355 and §411.357 of our
regulations, including exceptions for bona fide employment
relationships (§411.357(c)), personal service arrangements
(§411.357(d)), arrangements involving fair market value
compensation (§411.357(l)), arrangements involving indirect
compensation (§411.357(p)), and services provided by an
academic medical center (§411.355(e)). We believe that
properly structured arrangements involving physician
participation in an incentive payment or shared savings
program may meet the requirements of one or more of the
existing physician self-referral exceptions for
compensation arrangements. (An arrangement that implicates
the physician self-referral statute need not satisfy more
than one exception.) We request comments on [54] the
extent to which a “stand-alone” exception(s) for incentive
payment and shared savings programs is necessary given the
existence of other compensation exceptions, including the
ones mentioned above. We request comments on [55] whether
it would preferable for us to modify aspects of the
412