HHS proposes Stark Law, Anti-Kickback Statute reforms to support value-based and coordinated care10.10.19
Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued proposed rules related to the Stark Law, creating new value-based exceptions to better fit the industry’s shift towards paying providers for value instead of volume. At the same time, the Office of Inspector General released its own set of proposed rules related to the Anti-kickback Statute, aimed at offering flexibility for innovation and improved coordinated care.
In addition to the above broad proposals, both CMS and OIG also proposed rules clarifying how to determine fair market value, when it is appropriate to donate cybersecurity technology, and how providers may encourage patient engagement, among other areas.
If history is any guide, it is likely that stakeholders (e.g., trade associations, lobbyists, hospital government relations professionals) will quickly engage with their constituencies, identify priorities (good and bad), form coalitions, and begin targeting their message.
Comments must be received by 5:00 PM on December 31, 2019. Providers and stakeholders should closely review the proposed rules and pose comments supporting changes with which they agree and providing information/counterarguments for aspects of the rules that would not be beneficial to their interests.
While the stated goal is to reduce regulatory burdens, rest assured there will be winners and losers in whatever approach the government takes.
Waller will be closely monitoring developments related to the revised regulations, and we will provide additional analysis in the weeks to come. Our healthcare attorneys are available to assist in the comment submission process to effectively advocate and express the concerns of healthcare providers.