What determines fair and reasonable pricing?
While complying with all applicable laws and regulations, the price basis for acquiring health care resources should be as flexible as possible. At a minimum this should include the direct purchasing of provider time (by FTE or by hour) and health care services (cost per procedure or relative value unit (RVU)-based contracts), as appropriate. Similarly, VHA should be allowed to use the same reimbursement methodologies as other government agencies, such as the Centers for Medicare and Medicaid (CMS), Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), or TRICARE. Contracts should be based on market prices as assessed by appropriate local and regional market analyses. Contracts should not exceed applicable Medicare rates unless there is adequate justification documented in the contract file. Additional requirements for contract physicians (such as administrative activities, supervision of trainees, on call availability, rounds, etc.) and/or additional con
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