Like safe, value-based ports, the OIG proposes to exclude, directly or indirectly, results-based payments by a pharmaceutical manufacturer; Manufacturer, distributor or supplier of DMEPOS; or a lab. The OIG is also considering excluding pharmacies, pharmacy managers, wholesalers and distributors. In addition, the OIG can only limit this safe port to value-oriented business participants. “Value-based enterprise” is defined overall as an agreement whereby participants agreed on value-based cooperation, which involves coordinating and improving the quality of care provided to a targeted patient population and a reasonable reduction in costs to payers, without reducing the quality of care provided to a target patient population. For more information on HHS`s proposed changes to reduce barriers to value-based agreements, check out our first part of this series of blogs. 4. At reasonable intervals, but at least annually, the health centre will re-evaluate the agreement to ensure that the plan is likely to continue to meet the standard set at (w) (3) in this section and simultaneously document the reassessment. The documents are made available to the secretary upon request. Agreements can only be renewed or renegotiated if the health centre reasonably expects that the standard set out in paragraph 3 of paragraph 3 of this section will be met during the next contract period. Renewed or renegotiated agreements must meet the requirements of paragraph (w) (3) in this section. (iv) is state-approved, is under contract with an employer, a union fund or a company covered by health insurance, as described in the terms (ii) and (iii) of this definition, and receives a fee for the management of the plan that reflects the fair value of these services. (D) Payments for goods and services eligible for reimbursement by the federal health program must meet the following two standards – B) Safe port conditions for the recruitment of practitioners are met in accordance with paragraph n of this section. 2.
Where the company receiving the seller`s goods or services is a health care provider, the purpose of the group policy must inform the company at least once a year and the secretary, upon request, of the amount each seller receives with respect to purchases made by or on behalf of the company.
Recent Comments