用醋抓苍蝇:对医疗保险和医疗补助自我披露计划的批评。

Jean Wright Veilleux
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引用次数: 0

摘要

本文认为,卫生和人类服务部以及医疗保险和医疗补助服务中心(CMS)目前执行《患者转诊道德法案》(“斯塔克法”)的方法是不必要的惩罚性的,并且不鼓励医疗保健提供者自我披露即使是非常轻微的违反斯塔克法的行为。本文提出了一些鼓励提供者自我披露的具体变化,并建议CMS在《患者保护和平价医疗法案》的授权下创建一个示范项目来测试改革。一个示范项目提供了一个完美的工具来证明,增加斯塔克法的自我披露协议可以降低政府的执行成本,提高项目的完整性,并鼓励提供者负责任地处理在医疗保险这样一个庞大的政府项目中出现的不可避免的小失误。
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Catching flies with vinegar: a critique of the Centers for Medicare and Medicaid self-disclosure program.

This Article argues that the current approach of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to enforcement of the Ethics in Patient Referrals Act (the "Stark Law") is unnecessarily punitive and discourages health-care providers from self-disclosing even very minor violations of the Stark Law. This Article suggests a number of specific changes to encourage provider self-disclosure and proposes that CMS create a demonstration project under the authority of the Patient Protection and Affordable Care Act to test the reforms. A demonstration project provides the perfect vehicle to prove that increased self-disclosure protocols for the Stark Law can decrease the government's costs of enforcement, improve program integrity, and encourage providers to deal responsibly with the inevitable minor lapses in compliance that arise in such an enormous government program as Medicare.

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