HHS Publishes Proposed Changes to Stark & Anti-Kickback Rules

From ACG Legislative and Public Policy Council Chair, Whitfield L. Knapple, MD, FACG

On Wednesday, the U.S. Department of Health and Human Services (HHS) released the anticipated proposed regulatory changes to the Stark Law and Anti-Kickback Statute. ACG is culling through the proposals and will provide the practical guidance and assessments for clinical GI. As excepted, the proposed changes provide exemptions for value-based payment arrangements and HHS-approved alternative payment models (APMs). Among the highlights:

  • Permanent exceptions to the Stark law for providers in value-based payment arrangements. HHS is also asking for feedback on whether “cost of care” information should be provided in a referral.
  • New Anti-Kickback safe harbors, such as for care coordination agreements to improve quality, health outcomes and/or efficiency. Also, for value-based arrangements with “substantial” downside or full financial risk,” and for providers participating in CMS-approved payment models.
View the “Modernizing and Clarifying the Physician Self-Referral Regulations” proposed rule by clicking here.

View the “Revisions to Safe Harbors Under the Anti-Kickback Statute” proposed rule by clicking here.

Stay tuned for more information on the proposed Stark Law and Self-Referral changes, tailored for the GI clinician.

Learn More About Ancillary Services and APM Legal Issues: Register for the "Roadmap for a Successful Community or Academic GI Practice" Course

Important: How can you legal structure a anesthesia services centers? How can you successfully negotiate an APM bundle payment? What about other ancillary services?

Register for the ACG’s “Roadmap for a Successful Community or Academic GI Practice” Course. Among this year’s agenda include these important and timely talks on:

  • “How to Legally Structure an Anesthesiology Provider Agreement for Your Endoscopy Center” from Ann M. Bittinger, JD
  • “APM Guidance: The ‘How To’ When Negotiating a Bundled Payment Plan” from Ralph D. McKibbin, MD, FACG
  • “The “Lesser Known” Ancillaries – Still a Good Opportunity?” from Harry E. Sarles, Jr., MD, FACG

What is the Practice Management toolbox?

Gastroenterologists in private practice find themselves working in a time of unprecedented transformation. Pressures are high as they make important management decisions that profoundly affect their business future, their private lives, and their ability to provide care to patients. The ACG Practice Management Committee has a mission to bring practicing colleagues together to explore solutions to overcome management challenges, to improve operations, enhance productivity, and support physician leadership. It was in this spirit that the Practice Management Toolbox was created.

The Toolbox is a series of short articles, written by practicing gastroenterologists, that provide members with easily accessible information to improve their practices. Each article covers an issue important to private practice gastroenterologists and physician-lead clinical practices. They include a brief introduction, a topic overview, specific suggestions, helpful examples and a list of resources or references. Each month a new edition of the Toolbox will be released and will then remain available here along with all previous editions. The Practice Management Committee is confident this series will a provide valuable resource for members striving to optimize their practices.