[Federal Register Volume 71, Number 180 (Monday, September 18, 2006)]
[Notices]
[Pages 54664-54665]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-7738]


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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 
[email protected]. 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