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On Nov. 20, the Centers for Medicare & Medicaid Services issued its final rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law, also known as the Stark Law.
The final rule, which is more than 600 pages, is the first significant update to the Stark Law since it was enacted in 1989. It reflects significant reforms to modernize the regulations interpreting the Stark Law that are intended to avoid discouraging value-based health care delivery and payment systems that have developed since the Stark Law went into effect.
A major change in this final rule creates new, permanent exceptions to the Stark Law for value-based arrangements. It also finalizes exceptions that provide new flexibility for certain arrangements, such as donations of cybersecurity technology that safeguard the integrity of the health care ecosystem. The final rule also provides additional guidance on several key requirements that must often be met for providers to comply with the Stark Law, including how to determine if physician compensation meets the “fair market value” requirement. Finally, the final rule also provides clarity and guidance on a range of other technical compliance requirements intended to reduce administrative burdens.
These and other changes to modernize and clarify the physician self-referral regulations were advocated by CHA and the American Hospital Association in comment letters during the administrative review process.
CHA will distribute a detailed summary of the final rule shortly. The final rule is expected to be published on Dec. 2.
