CMS finalizes changes to physician self-referral regulations
CMS announced it has finalized changes to the Physician Self-Referral Law. The law prohibited physicians from making referrals to an entity for certain health care services if the physician had a financial relationship with the entity.
The changes made to the Physician Self-Referral Law, also known as “Stark Law,” will create clearer paths for providers to serve patients through enhanced coordinated care arrangements, resulting in better access and outcomes for patients, according to a release from CMS. CMS noted this final rule will ensure the regulations interpreting the Stark Law will allow for changes that will help modernize the health care system.
The release noted the proposed policies finalized in the rule include the following:
- new, permanent exceptions for value-based arrangements that permit physicians and other health care providers to design and enter into value-based arrangements without fear that legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the physician self-referral law;
- additional guidance on key requirements of the exceptions to the physician self-referral law to make it easier for physicians and other health care providers to make sure they comply with the law;
- protection for non-abusive, beneficial arrangements that apply regardless of whether the parties operate in a fee-for-service or value-based payment system, such as donations of cybersecurity technology that safeguard the integrity of the health care ecosystem; and
- a reduction in administrative burdens that drive up costs by taking money previously spent on administrative compliance and redirecting it to patient care.
“When we kicked off our Patients Over Paperwork initiative in 2017, we heard repeatedly from frontline providers that our outdated Stark regulations saddled them with costly administrative burden and hindered value-based payment arrangements,” CMS Administrator Seema Verma, said in the release. “That sound you hear is the mingled cheers and exclamations of relief from doctors and other health care professionals across the county as we lift the weight of our punishing bureaucracy from their backs.”
CMS noted all of the provisions in the rule will go into effect 60 days from its display date in the Federal Register, unless otherwise specified in the rule.
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