On June 25, 2018, the Centers for Medicare and Medicaid Services (CMS) published a formal request for information, seeking comment from ACG members and other stakeholders on how to better promote value-based payments. Specifically, CMS is asking industry leaders what the Agency can do to break down barriers posed by the federal Physician Self-Referral Law (known as the Stark Law). It’s a nod that CMS’ desire to get away from fee-for-service is so strong, that it is willing to consider regulatory modifications to the Stark Law. According to the publication, CMS wants to know how the Stark Law has stymied efforts to participate in integrated delivery models, alternative payment models, and arrangements to incentivize improvements in outcomes and reductions in costs. CMS asks what new exceptions are needed to the Stark Law to promote these arrangements.
Ms. Bittinger is a health law expert at Bittinger Law Firm in Jacksonville, FL.
ACG will be providing comment based on feedback from membership. Please forward any specific examples of undue burdens to the ACG staff.
You can also offer a comment directly to CMS. The deadline for response is August 24, 2018. This is simple using ACG’s advocacy tool. Click on the link below to provide real-world examples of how the antiquated Stark Law hinders this push towards more value-based care.
Submit your comment to CMS here.
Tell Congress as well!
From ACG Legislative and Public Policy Chair, Whitfield L. Knapple, MD, FACG
Legislation has been introduced in both the U.S. House and Senate which aims to modernize Stark Law and physician self-referral limitations for those GI practices wishing to explore alternative payment models (APMs). The “Medicare Care Coordination Improvement Act of 2017″ (S. 2051/HR.4206), introduced by Senators Portman (R-OH) and Bennet (D-CO), and Representatives Bucshon (R-IN), Ruiz, MD (D-CA), Marchant (R-TX) and Kind (D-WI), allows CMS to create exemptions for medical practices who are in the process of joining an APM. CMS continues to explore better approaches and incentives for specialists to join an APM.
More must be done, however, as current APMs may not be the right fit for smaller, non-integrated GI practices. Thus, ACG, along with several other medical associations across the healthcare spectrum, are in support of S. 2051/HR.4206, as the legislation may allow for more creativity and opportunity for independent GI practices to explore APMs without the fear of Stark Law violations.
We need your help: please reach out to your elected officials and urge them to support these important health policy issues impacting ACG members and your patients. ACG’s legislative action center makes this process quick and simple.