The Trump administration on Wednesday unveiled plans to loosen two anti-corruption laws for doctors, in a bid to promote new ways of delivering coordinated health care while attempting to preserve the laws’ core aim of combating fraud and abuse.
Physician groups have long sought changes to the anti-kickback law and the Stark self-referral law, saying the cumbersome rules impede the close provider relationships necessary to pay for health outcomes rather than the volume of services. The laws restrict doctors from accepting payments that induce business under Medicare and from referring patients to other businesses in which they have a financial interest, respectively.
“We serve patients poorly when government regulations gather dust in the attic,” Centers for Medicare and Medicaid Services Administrator Seema Verma said in a statement. “They become ever more stale and liable to wreak havoc throughout the healthcare system.”
CMS and the Office of Inspector General for the Health and Human Services Department laid out definitions in two separate proposals for various value-based care situations, which would qualify for exceptions to the self-referral law. The agencies likewise proposed expanding “safe harbor” exceptions for things like sharing electronic health records software, as well as adding a new exception for sharing cybersecurity technology.
Examples of financial and care coordination arrangements could include primary care and specialty doctors sharing data analytics, or hospitals sharing data and care coordination teams with a patient’s primary doctor. Physicians could also give patients home health aides or medical devices to help monitor them remotely, such as smart pillboxes.
CMS initially sought public feedback on revising the laws in June 2018.
Both proposals will have a 75-day comment period after they are published in the Federal Register.