Regulators Sprint to Catch Up to Evolving Healthcare Payment Systems

On October 9, 2019, the Centers for Medicare and Medicaid Services (CMS) released proposed updates to the Physician Self-Referral Law, also known as the Stark Law. On the same day, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) announced proposed changes to the Federal Anti-Kickback Statute and the Civil Monetary Penalty Law (CMP). The Stark Law prohibits a physician from referring patients for certain designated health services (DHS) to an entity in which that physician (or the physician’s family member) maintains a financial interest, unless an exception applies. The AKS is a criminal law that prohibits the payment of remuneration to induce or reward referrals or other business payable by a federal healthcare program. The CMP authorizes civil monetary penalties for certain fraud and abuse violations, including the provision of free or discounted items or services that may influence Medicare or Medicaid beneficiaries to receive services from a particular provider.

Source: https://www.jdsupra.com/legalnews/regulators-sprint-to-catch-up-to-16405/