Industry Says OIG Proposed Gainsharing Rule Could Hurt Innovation
This article was originally published in The Gray Sheet
Medical device groups worry some that proposed provisions and interpretations in a draft OIG rule could expand exemptions for gainsharing agreements between hospitals and physicians that will hinder the ability of innovative products to gain traction in the market.
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The legislation would repeal the much maligned sustainable growth rate formula and it also includes a collection of miscellaneous Medicare reforms, including provisions on gainsharing, durable medical equipment and remote monitoring.
Although CMS’ newly finalized rule on accountable care organizations has allayed health care providers’ fears of a program too burdensome to bother with, medical device manufacturers remain worried that ACOs will curb patient access to their products.
A hospital-physician gainsharing demonstration project in New Jersey does not include product standardization incentives, but does offer physicians the potential to earn extra money by reducing procedure or test volume to meet statewide norms, according to one of the program developers