The Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) seeking recommendations and input from the public on how to address any undue impact and burden of the physician self-referral law (also known as the “Stark Law”), focusing in part on how the law may impede care coordination.
Over the past year, CMS has engaged with the provider community in a discussion about regulatory burden issues. This included publishing a request for information soliciting comments about areas of high regulatory burden. One of the top areas of burden identified in the over 2,600 comments received was compliance with the Stark Law and its accompanying regulations. In response to these concerns, CMS undertook a review of the existing regulations to determine where the agency could consider potential areas for burden reduction. In coordination with Department of Health & Human Services (HHS) Deputy Secretary Eric Hargan, CMS is now soliciting specific input on a range of issues identified with the Stark Law to help the agency better understand provider concerns and target its regulatory efforts to address those concerns.
“Removing unnecessary government obstacles to care coordination is a key priority for this Administration,” Hargan says in a release. “We need to change the healthcare system so that it puts value and results at the forefront of care, and coordinated care plays a vital role in this transformation. Reviewing the Stark Law regulations is an important step forward to building a value-based system, which is one of Secretary Azar’s priorities at HHS. I am personally leading our recently launched Regulatory Sprint to remove barriers and help providers deliver the best team-based care. We welcome public input to get us there.”
CMS Administrator Seema Verma says, “We are looking for information and bold ideas on how to change the existing regulations to reduce provider burden and put patients in the driver’s seat. Dealing with the burden of the physician self-referral law is one of our top priorities as we move towards a health care system that pays for value rather than volume.”
As described by Verma in a recent blog post, the “Stark Law was enacted in the 1980s to help protect Medicare and its beneficiaries from unnecessary costs and other harms that may occur when physicians benefit from referring patients to health care entities with which they have a financial relationship. The law prohibits a physician from making referrals for certain health care services to an entity with which he or she (or an immediate family member) has a financial relationship. There are statutory and regulatory exceptions, but in short, a physician cannot refer a patient to any service or provider in which they have a financial interest.”
According to a release, CMS is particularly interested in the public’s input on the structure of arrangements between parties that participate in alternative payment models or other novel financial arrangements, the need for revisions or additions to exceptions to the physician self-referral law, and terminology related to alternative payment models and the physician self-referral law. Public comments are by August 24, 2018 and can be made at https://www.federalregister.gov/documents/2018/06/25/2018-13529/medicare-program-request-for-information-regarding-the-physician-self-referral-law.