Worried that the Stark law may stand in the way of the move to value-based care and alternative payment models, the government wants ideas on how to reduce the regulatory burdens of the physician self-referral law.
The Centers for Medicare & Medicaid Services (CMS) issued a request for information (PDF) seeking recommendations and public input on how to reduce the burden of the federal anti-kickback law. They are focused on how it may impede care coordination, a key to healthcare systems that deliver value.
“To achieve a truly value-based, patient-centered healthcare system, doctors and other providers need to work together with patients. Many of the recent statutory and regulatory changes to payment models are intended to help incentivize value-based care and drive the Medicare system to greater value and quality," CMS administrator Seema Verma wrote in a blog post. "The Stark Law and regulations, in its current form, may hinder these types of arrangements.”
Comments on the RFI are due by August 24.
The Stark law prohibits physicians from referring patients to other providers with whom they have a financial relationship. Verma said that as it is written, the law may prohibit some relationships designed to enhance care coordination, improve quality and reduce waste.
The law was one of the top areas identified in over 2,600 comments the agency received when it asked providers for comment about regulations that create burdensome regulatory hurdles, Verma said.
The American Hospital Association and other provider groups have argued that the Stark law, which was first passed in 1989, can hinder the growth of care coordination. Critics have long said the law needs reform to strike a balance between new payment models and the original intent of the law, which was to prevent financial relationships between providers from influencing patient care.
In a statement, Verma said CMS is looking for “bold ideas” and that reducing the burden of the physician self-referral law is a top priority in the move toward value-based care.
CMS put out the request for information in coordination with Department of Health and Human Services Deputy Secretary Eric Hargan. It asks for specific input on a range of issues identified with the Stark law to better understand concerns of providers and target efforts to address them.
“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,” Hargan said in the statement.
The agency said it is particularly interested in input on the structure of arrangements between parties that participate in alternative payment models or other novel financial arrangements and the need for revisions or additions to exceptions to the law.
CMS earlier this year formed an interagency group to look at the regulatory barriers posed by the Stark law as part of its efforts to re-examine existing regulations. CMS, the Department of Health and Human Services Office of Inspector General, HHS General Counsel and the Department of Justice will work together to review the law.