,i #aacth ,,congress #ast ,session ,h4 ,r4 #adhg ,,in ,,the ,,house ,,of ,,representatives ,april #aa1 #bjac ,mr4 ,mc,dermott introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend titles ,,xviii and ,,xi of the ,social ,security ,act to establish an exception from the physician self-referral prohibition and a safe harbor from ,federal antikickback and other sanctions for incentive payments made by hospitals to physicians under certain incentive payment programs4 #a4 ,short title ,this ,act may be cited as the ,improved ,health ,care at ,lower ,cost ,act of #bjac4 #b4 ,exception and safe harbor from ,federal sanctions for incentive payments from hospitals to physicians under certain incentive payment programs 7a7 ,findings ,congress finds the following3 7#a7 ,the ,department of ,health and ,human ,services has been engaged in approving1 on a project-by-project basis1 gain-sharing arrangements under demonstration authority for nearly a decade4 ,based on the knowledge gained from such demonstration projects1 the ,department is capable of developing and applying standards for permitting such arrangements more generally without the use of such authority4 7#b7 ,the ,inspector ,general of the ,department of ,health and ,human ,services has issued a special advisory bulletin in ,july #aiii that indicates that there is no general authority for waiving sanctions for any gain-sharing arrangements between physicians and hospitals4 7#c7 ,due to lack of capitalization1 size limitations1 risk characteristics1 and other factors1 many hospitals and physicians have been unable or unwilling to enter into gain-sharing types of arrangements that meet the requirements of the shared savings program4 7b7 ,purpose ,the purpose of this section is to establish general statutory authority within the ,department of ,health and ,human ,services to recognize gain-sharing and other incentive payment programs1 other than the shared savings program1 that align incentives among hospitals and physicians to improve efficiency and decrease costs while maintaining or improving quality care4 7c7 ,exception from physician self-,referral prohibition ,section #ahgg7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acienn7e77 is amended by adding at the end the following new paragraph3 7#i7 ,payments under certain incentive payment programs between hospitals and physicians 7,a7 ,in general ,in the case of a monetary incentive payment which is made by a hospital to a physician under an incentive payment program 7as defined in subparagraph 7,b77 that meets requirements established by the ,secretary in consultation with the ,attorney ,general and the ,inspector ,general of the ,department of ,health and ,human ,services for purposes of this paragraph4 7,b7 ,incentive payment program defined ,in this paragraph1 the term incentive payment program means a program that is designed to align incentives among hospitals and physicians 7through techniques such as product standardization1 the substitution of lower cost products1 and care coordination initiatives that encourage medically appropriate decreases in length of stay7 to improve efficiency and decrease costs while maintaining or improving quality4 4 7d7 ,safe harbor from antikickback and other ,federal sanctions 7#a7 ,section #aabh;,b7b77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7b77#c77 is amended-- 7,a7 by striking and at the end of subparagraph 7,i72 7,b7 in subparagraph 7,j71 by moving the indentation #b ems to the left and by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,k7 any monetary incentive payment which is made by a hospital to a physician under an incentive payment program 7as defined in subparagraph 7,b7 of section #ahgg7;e77#i77 that meets requirements established by the ,inspector ,general of the ,department of ,health and ,human ,services in consultation with the ,attorney ,general for purposes of applying this subparagraph 7which requirements needs not be the same as those established under subparagraph 7,a7 of such section74 4 7#b7 ,section #aabh;,a7b77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;a7b77#a77 is amended by inserting 7other than a monetary incentive payment described in section #aabh;,b7b77#c77,k77 after makes a payment4 7e7 ,publication of guidance ,the ,secretary of ,health and ,human ,services and the ,inspector ,general of the ,department of ,health and ,human ,services-- 7#a7 not later than #f months after the date of the enactment of this ,act1 shall jointly publish a solicitation of comments to carry out the amendments made by this section2 and 7#b7 not later than #ab months after such date of enactment1 shall publish1 jointly or separately1 such guidance or rules1 which may be effective on an interim1 final basis1 as may be necessary to carry out such amendments in a timely manner4 7f7 ,construction ,nothing in this section 7or the amendments made by this section7 shall be construed as affecting the operation of the shared savings program4 7g7 ,shared savings program defined ,in this section1 the term shared savings program means such program under section #ahii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;jjj74