Medical Economics October 9, 2019
Keith A Reynolds

The Trump Administration seeks to exempt value-based arrangements from the Medicare physician self-referral law, or Stark Law, and the Anti-Kickback Statute, the first major change to these laws in years.

The Stark Law prohibits physicians from making referrals for certain healthcare services payable by Medicare if the physician or an immediate family member holds a financial stake and stops any entity from billing Medicare for services that derive from a prohibited referral, according to a fact sheet distributed by CMS.

While the law was implemented at a time when healthcare was almost exclusively based around the fee-for-service model, both Medicare and private payers are increasingly moving toward a value-based pay model, for which the Stark Law has been unable...

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Topics: CMS, Govt Agencies, Health System / Hospital, HHS, Insurance, OIG, Payment Models, Physician, Primary care, Provider, Regulations, Value Based
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