In conjunction with its interim report to Congress about a specialty hospital provision in the Deficit Reduction Act, the CMS said it will send a survey to hospitals to gain information about physician investment interests. Among other steps, the CMS said it is developing refinements to its hospital inpatient payment system to improve accuracy and lead to better incentives for hospital quality and efficiency; expanding the list of surgical procedures eligible for payment in ambulatory surgical centers beginning in 2008; and including a provision that would require all hospitals with specialized capabilities to accept appropriate transfers of unstable patients covered under the Emergency Medical Treatment and Labor Act. The CMS also said it will send a survey to about 130 specialty hospitals and 270 general acute-care hospitals seeking information about physician investment interests and provision of care to low-income and charity patients.
The report said the CMS intends to consult with staff from the HHS Office of the Inspector General for technical guidance on matters that relate to enforcement under the anti-kickback statute. "The first thing that strikes us is the continued emphasis on payment changes," Caroline Steinberg, vice president for trends analysis at the American Hospital Association, said of the report. "It is disappointing. It doesn't address the issue of physician self-interest and self-referral," she said, adding that the AHA hopes the CMS will employ a "rigorous approach" to examining physician investment in specialty hospitals. In a news release, the CMS said it intends for the report to generate comments as it finalizes its strategic plan, including ways the CMS can support other government regulators that oversee important aspects of specialty-hospital activities.