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CMS made impactful changes to the Federal physician self-referral law’s (i.e., Stark Law’s) regulations in its Final Rule that were effective January 19, 2021 (with the exception of the changes to 42 C.F.R. § 411.352(i) that are effective January 1, 2022). Although lengthy (190 pages/3-column format), the Final Rule is worth the read with multiple clarifications and revisions to the dense regulations.
In this first part of our two-part blog, each reader will find gems in the Final Rule that are impactful, but we note particularly the following key changes, clarification, and discussion:
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In late November, the Centers for Medicare and Medicaid Services and the Office of the Inspector General released their final rules revising the Physician Self-Referral Law (the “
Stark Law”) and the Anti-Kickback Statute. The changes are sweeping and while they are generally designed to facilitate coordinated care, some of the changes will impact providers more broadly. Most provisions of the final rules are effective on January 19, 2021. The following is a brief overview of the hundreds of pages of rules and commentary:
The Stark Law Final Rule
New Value-Based Exceptions: New exceptions were created to permit compensation arrangements in the context of value-based arrangements designed to coordinate and improve the quality of care for patients and to lower costs.
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In November 2020, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) each issued long-awaited final rules that modernize and change the Stark Law and Anti-Kickback Statute (AKS) regulations, respectively. The final rules are generally effective on January 19, 2021. Although these rules are complex and extensive, they aim to assist providers to transition to value-based care by providing greater flexibility and clarity around participation in value-based and coordinated care arrangements. According to CMS and OIG, the additional flexibility in the Stark Law and the AKS does not diminish the laws’ ability to safeguard against government health care program abuses nor does it diminish CMS’ and OIG’s ability to use its enforcement powers to punish such abuses.
Thursday, December 10, 2020
In November 2020, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) each issued long-awaited final rules that modernize and change the Stark Law and Anti-Kickback Statute (AKS) regulations, respectively. The final rules are generally effective on January 19, 2021. Although these rules are complex and extensive, they aim to assist providers to transition to value-based care by providing greater flexibility and clarity around participation in value-based and coordinated care arrangements. According to CMS and OIG, the additional flexibility in the Stark Law and the AKS does not diminish the laws’ ability to safeguard against government health care program abuses nor does it diminish CMS’ and OIG’s ability to use its enforcement powers to punish such abuses.