Trump Administration, Industry Want Stark Law Changes To Accommodate ACO Formation
The US administration and the medical device industry are pushing Congress to create exceptions and waivers to Stark law requirements that prohibit physician self-referrals to radiological clinics or other medical facilities in which they have a financial interest. They say the law inhibits formation of accountable care organizations fostered by the Centers for Medicare and Medicaid Services, and hinders value-based health care.
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The US HHS Office of Inspector General on Aug. 27 issued a request for information on ways the department may loosen provisions of the anti-kickback statute – such as restrictions on Accountable Care Organization arrangements – that may be acting as barriers in the pursuit of value-based care.
The US Center for Medicare and Medicaid Services launched a request seeking information from the public on how to reduce burdens of the physician self-referral “Stark Law,” which is intended to prevent physicians from enriching themselves with referrals, but has challenged health-care organizations, particularly those participating in accountable care organizations (ACOs), for several years.
Industry groups told the US Medicare agency it should seek the input of a broader array of stakeholders – including medtech companies – in developing future episode-of-care pay models. They also argued that participation in the programs should be voluntary, and that the pay models should account for patient outcomes longer than 90 days following initial care. The responses came in comments to CMS following its proposal to scale back its joint replacement bundled payments program and eliminate a cardiac-care version.