CMS seeks information to reduce Stark law burden

The CMS has issued a request for information to determine how it can minimize the regulatory barriers of federal anti-kickback laws and support providers' move to value-based care.

Hospitals have said the Stark law makes it difficult for physicians to enter innovative payment arrangements because they are not susceptible to fair-market value assessment, a Stark requirement. Now, they'll get the chance to answer 20 questions for the CMS on how the law's enforcement should change.

"Removing unnecessary government obstacles to care coordination is a key priority for this administration," HHS Deputy Secretary Eric Hargan said in a comment. "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."

The CMS asked stakeholders to share ideas on how to apply the physician self-referral law to financial arrangements among participants in alternative payment models and other novel financial arrangements.

The agency also asked whether it should experiment with transparency safeguards to address how physicians' financial self-interest affects medical decision-making.

The Stark law prohibits doctors from referring Medicare patients to hospitals, labs and colleagues with whom they have financial relationships unless they fall under certain exceptions. Physicians and hospitals can be found liable even if they didn't intend to violate the law, and offenses can carry significant financial penalties.

The law prevents hospitals from paying providers more when they meet certain quality measures, such as reducing hospital-acquired infections, while paying less to those who miss the goals. Those are key tenets of value-based care.

Despite the agency's focus in reducing barriers regarding the law, CMS Administrator Seema Verma noted earlier this year that Congress may ultimately need to intervene to make meaningful changes to the Stark law to reduce its effect on value-based transitions.

President Donald Trump's 2019 budget also suggested establishing a new Stark law exception for alternative payment model arrangements.