Shay Albert W, Murphy Stacey L
Sonnenschein Nath & Rosenthal, Washington, DC, USA.
Manag Care Q. 2002 Spring;10(2):41-6.
It has been roughly a year since the Office of Inspection General issued Advisory Opinion 01-1 approving a gainsharing arrangement between a hospital and a group of cardiac surgeons. Advisory Opinion 01-1 caught some by surprise, given the position taken by the OIG in its July 1999 Special Advisory Bulletin that gainsharing arrangements were contrary to the provisions of Section 1128A(b)(1) of the Social Security Act. To many, the Special Advisory Bulletin put an end to any plans to establish a gainsharing arrangement. Many questioned whether Advisory Opinion 01-1 would result in a renewed interest in establishing gainsharing arrangements between hospitals and physicians. If the number of OIG advisory opinions issued by the OIG addressing gainsharing arrangements subsequent to Advisory Opinion 01-1 is any indication, the answer to this question is a resounding no. It is possible, however, that some hospitals established gainsharing programs but simply chose not to seek an OIG advisory opinion on the arrangement. Alternatively, some hospitals may have decided not to enter into true gainsharing arrangements with physicians, but instead are exploring hybrids of true gainsharing arrangements more akin to management or consulting arrangements.
自监察长办公室发布第01-1号咨询意见批准一家医院与一组心脏外科医生之间的收益共享安排以来，大约已有一年时间。第01-1号咨询意见让一些人感到意外，因为监察长办公室在其1999年7月的特别咨询公告中表明收益共享安排违反了《社会保障法》第1128A(b)(1)条的规定。对许多人来说，这份特别咨询公告使任何建立收益共享安排的计划都泡汤了。许多人质疑第01-1号咨询意见是否会导致医院和医生重新对建立收益共享安排产生兴趣。如果以监察长办公室在第01-1号咨询意见之后发布的涉及收益共享安排的咨询意见数量为依据的话，这个问题的答案是响亮的“不”。然而，有可能一些医院已经建立了收益共享计划，但只是选择不就该安排寻求监察长办公室的咨询意见。或者，一些医院可能决定不与医生达成真正的收益共享安排，而是在探索更类似于管理或咨询安排的真正收益共享安排的混合形式。
