Medicare: Physician Incentive Payments by Hospitals Could Lead to Abuse

摘要

During the past year, two physician incentive plans offered by hospitals have come under investigation for possible violation of Medicare law, one by the Department of Justice and the other by the Department of Health and Human Services' Office of Inspector General. These two cases have raised questions about the adequacy of the Medicare statute to deter abuses that may arise under the incentives of the Medicare prospective payment system for hospitals. At the request of the Chairman, Subcommittee on Health, House Committee on Ways and Means, GAO obtained information on existing and proposed physician incentive plans and analyzed the plans to (1) assess their legality under current law and (2) determine the potential abuses that could arise under them in view of the changed incentives under prospective payment.