Managed Healthcare Executive December 13, 2019
Dennis Williams, Jonathan Lahn, Chad D. Ehrenkranz

In early October of this year, the HHS Office of Inspector General (OIG) and CMS released notices of proposed rulemaking that seek to expand, modify and introduce new regulatory “safe harbors” and exceptions, respectively.

These Anti-kickback Statute (AKS) safe harbors and Ethics in Patient Referrals Act (the Stark Law) exceptions, when squarely met, afford protection for certain financial relationships between healthcare providers and other entities under the AKS and Stark Law.

The stated purpose of the proposed changes is to remove barriers to the implementation of “value-based” patient care models in order to “transition [from] healthcare delivery and payment mechanisms based on the volume of items/services provided to mechanisms based on quality of care and control...