ADEA Washington Update

CMS Seeks Recommendations on Physician Self-referral Law

(HHS, Medicare and Medicaid Services) Permanent link   All Posts

Under the Trump Administration, the Centers for Medicare & Medicaid Services (CMS) has sought to reduce or limit many regulatory measures they believe impede care coordination and delivery. CMS issued a Request for Information (RFI) to obtain recommendations from the public on the 1989 physician self-referral law known as the “Stark law,” named after former Congressman Pete Stark (D-CA). According to the Office of Inspector General at the U.S. Department of Health and Human Services (HHS), the Stark law is one of the five most important federal fraud and abuse laws that apply to physicians.

Under the Stark law, a dentist may not refer Medicare or Medicaid patients to a “designated health services” entity where the dentist or an immediate family member has a direct or indirect financial relationship, unless an exception applies.

CMS wants recommendations specifically on the structure of arrangements between parties that participate in alternative payment models or other innovative financial arrangements, the need for revisions or additions to exceptions to the physician self-referral law and terminology related to alternative payment models and the physician self-referral law. Public comments on the RFI are due by Aug. 24, 2018.

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