The Trump administration pushed back on news that it is delaying a major overhaul to the Stark Law despite pushing back on a deadline to finalize the regulation by the end of this month.
The Centers for Medicare & Medicaid Services released a notice Wednesday that extends the timeline of a rule released in October 2019 that creates new exceptions to the Stark Law, which governs physician self-referrals. Providers have been eagerly awaiting the final rule and have been complaining the law has hindered value-based care payment agreements between hospitals and physicians.
The agency announced back in June it would finalize the rule this month.
However, the notice published Wednesday on the Federal Register said that the agency is “still working through the complexity of the issues raised by comments received on the proposed rule and therefore we are not able to meet the announced publication target date.”
CMS extended the timeline of publication until Aug. 31, 2021.
But CMS administrator Seema Verma pushed back that the agency is not putting the rule on hold, even though the deadline has been extended.
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Verma tweeted on late Wednesday that the agency is “not delaying the Stark rule and is working hard to finalize it.”
The proposed rule would create new exceptions to the 1989 law that bans physicians from referring patients to facilities they have a financial stake in.
Providers have worried that the law is inadvertently hindering physician participation in value-based payment models.
While CMS does provide waivers for certain arrangements such as accountable care organizations, those don’t apply to other types of arrangements created in the private sector or in Medicare.
The proposed rule would crate more exceptions to the stark law that enables private sector and other arrangements. The rule would require providers to spell out the arrangements, indicate the patient population affected and what the outcomes will be.
Another exception protects a hospital’s donation of cybersecurity software to a doctor’s office.
Both doctors and hospitals have issues with the proposed regulations. Doctor groups such as the American Medical Association opposed in comments a requirement that a value-based enterprise, a deal between two individuals to provide value-baed care, have a compliance program.
They are concerned about added paperwork and administrative burdens.
Hospitals, on the other hand, commented that they want more clarity on some parts of the regulation but overall are very pleased with the regulation in comments.