Stark law changes to open up value-based model participation, Verma says

March 04, 2019 / ROBERT KING 

CMS Administrator Seema Verma gave her first update on a major overhaul to the Stark law, saying that a key part of the regulation will remove a barrier to doctors participating in value-based arrangements.

A major part of the agency’s updates to the anti-kickback law is clarifying areas of noncompliance for doctors and updating the decades-old rules to reflect the shift from a fee-for-service model to value-based care, Verma said during the Federation of American Hospitals’ policy conference in Washington Monday.

“Some changes include clarifying regulatory definition of volume or value, commercial reasonableness and fair-market value,” Verma said of the updated regulation likely to be released later this year.

She added that the updated regulation will also address signatures, incorrect dates and other areas of “technical noncompliance.”

The goal of the update would be to address changes in the healthcare world that include the implementation of electronic health records and cybersecurity.

Hospitals and doctors have been clamoring for an update to the Stark law for years. They worry that doctors may violate the Stark law if they refer patients to a hospital or lab that they have a financial relationship with, which could prevent them from participating in value-based arrangements.


Chris J. Stewart

Chris currently serves as President and CEO of Surgio Health. Chris has close to 20 years of healthcare management experience, with an infinity to improve healthcare delivery through the development and implementation of innovative solutions that result in improved efficiencies, reduction of unnecessary financial & clinical variation, and help achieve better patient outcomes. Previously, Chris was assistant vice president and business unit leader for HPG/HCA. He has presented at numerous healthcare forums on topics that include disruptive innovation, physician engagement, shifting reimbursement models, cost per clinical episode and the future of supply chain delivery.

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