Health Care Programs: Fraud and Abuse; Civil Money Penalties for Hospital Physician Incentive Plans

Résumé

This proposed rule would implement section 9313(c) of the Omnibus Budget Reconciliation Act (OBRA) of 1986, as amended by section 6003(g)(3)(D)(i) of OBRA of 1989 and sections 4204(a)(3) and 4731(b)(1) of OBRA of 1990, by prohibiting a hospital (or a rural primary care hospital) from knowingly making incentive payments to a physician as an inducement to reduce or limit services provided to Medicare or Medicaid program beneficiaries who are under the care of that physician. Both a hospital who knowingly makes such payments and the physician who knowingly accepts such incentive payments would each be subject to civil money penalties (CMPs) of up to $2,000 for each individual for whom payments are made