[Federal Register: September 18, 2006 (Volume 71, Number 180)]
[Notices]
[Page 54664-54665]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr18se06-82]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5042-N]
RIN 0938-ZA90
Medicare Program: Solicitation for Proposals To Participate in
the Medicare Hospital Gainsharing Demonstration Program Under Section
5007 of the Deficit Reduction Act
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice is to inform interested parties of an opportunity
to apply to participate in the Medicare Hospital Gainsharing
Demonstration being implemented by CMS. The Medicare Hospital
Gainsharing Demonstration authorized under Section 5007 of the Deficit
Reduction Act (DRA) of 2005 was established to test and evaluate
methodologies and arrangements between hospitals and physicians
designed to govern the utilization of inpatient hospital resources and
physician work. The purpose of this demonstration is to improve the
quality and efficiency of care provided to Medicare beneficiaries and
to develop improved operational and financial hospital performance with
the sharing of remuneration payments between hospitals and physicians
in six projects, each project consisting of one hospital. Two projects
must be rural. This demonstration will be limited in scope: we intend
to focus on the short-term impacts of gainsharing programs.
DATES: Applications will be considered timely if we receive them no
later than 5 p.m., Eastern Standard Time (E.S.T.), on November 17,
2006.
FOR FURTHER INFORMATION CONTACT: Lisa Waters at (410) 786-6615 or
GAINSHARING@cms.hhs.gov. Interested parties can obtain a complete
solicitation, application, and supporting information on the following
CMS Web sites at http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1186805
or
[[Page 54665]]
http://www.cms.hhs.gov/DemoProjectsEvalRpts/.
Paper copies can be obtained by writing to Lisa Waters at the
address listed in the ADDRESSES section of this notice.
ADDRESSES: Mail or deliver applications to the following address:
Centers for Medicare & Medicaid Services, Attention: Lisa Waters, Mail
Stop: C4-17-27, 7500 Security Boulevard, Baltimore, Maryland 21244.
Because of staff and resource limitations, we cannot accept
applications by facsimile (fax) transmission or by e-mail.
Eligible Organizations: Section 5007 of the DRA provides that
hospitals receiving payment under section 1886(d) of the Social
Security Act are eligible to apply.
For the purpose of this demonstration, hospitals may provide
gainsharing payments to physicians (as defined in 1861(r)(1) or (3) and
practitioners (as described in 1842(b)(18)(C)). Section 5007(g)(4)
permits practitioners as described in section 1842(b)(18)(C) to
participate in this demonstration. We believe that the reference to
section 1842(e)(18)(C) in DRA section 5007(g) is a scrivener's error,
and that the reference should be to section 1842(b)(18)(C). Section
5007(g) explicitly provides that the reference to physicians who are
permitted to participate in the demo is deemed to include certain
practitioners, which we believe is clear evidence of Congress' intent
to include such practitioners in the demo. We also note the Conference
Report language specifically refers to the inclusion of practitioners
as part of the gainsharing arrangement. Since section 1842(e)(18)(C)
does not exist, and since section 1842(b)(18)(C) is, with the exception
of substituting (b) for (e), identical to that section], specifically
defines practitioners, we believe that section 1842(b)(18)(C) is the
one that Congress actually intended to reference, and that the
substitution of the (e) for the (b) is a scrivener's error. We do not
believe that this typographical error impedes any authority to
otherwise implement this demonstration. Furthermore, a comprehensive
list of all eligibility requirements can be found in the ``Eligible
Organizations'' section of the solicitation.
SUPPLEMENTARY INFORMATION:
I. Background
Section 5007 of the Deficit Reduction Act of 2005 (DRA) requires
the establishment of a qualified gainsharing demonstration program that
will test and evaluate methodologies and arrangements between hospitals
and physicians designed to govern the utilization of inpatient hospital
resources and physician work to improve the quality and efficiency of
care provided to beneficiaries and to develop improved operational and
financial hospital performance with the sharing of remuneration as
specified in the project. It will have a short-term focus given the
limited size of the demonstration.
II. Provisions of the Notice
This notice solicits applications to participate in the DRA Section
5007 Medicare Hospital Gainsharing Demonstration that will assist in
determining if gainsharing can align incentives between hospitals and
physicians to improve the quality and efficiency of care provided to
beneficiaries, which will promote improved operational and financial
performance of hospitals. The focus of each demonstration will be to
link physician incentive payments to improvements in quality and
efficiency. Each demonstration will provide measures to ensure that the
quality and efficiency of care provided to beneficiaries is monitored
and improved.
Overall, we seek demonstration models that result in savings to
Medicare. We will assure the demonstration is budget neutral.
III. Collection of Information Requirements
This information collection requirement is subject to the Paperwork
Reduction Act of 1995 (PRA); however, the collection is currently
approved under OMB control number 0938-0880 entitled ``Medicare
Demonstration Waiver Application.''
Authority: Section 5007 of the Deficit Reduction Act of 2005,
Pub. L. 109-171.
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program;
and No. 93.774, Medicare--Supplementary Medical Insurance Program)
Dated: August 7, 2006.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 06-7738 Filed 9-13-06; 3:58 pm]
BILLING CODE 4120-01-P