Trump Administration Reforms Stark, Anti-Kickback Rules

The Trump Administration reformed decades-old Stark law and Anti-kickback rules and regulations meant to combat provider fraud and abuse that doctors say have hampered efforts to coordinate patient care and form value-based care. The changes will reduce the burden on providers while attempting to boost value-based care and keep doctors from steering patients to select services that benefit them financially. 

With the final rule is set to take effect on January 19th, 2021, below is our AdvantEdge Insight.

• The Stark law hasn’t been significantly changed since it was enacted in 1989. 
• The reformed rules will allow the provider and other entities, such as medical device manufacturers, more flexibility to participate in value-based payment models and manage patient care in exchange for taking on risk.
• Providers can now join a “value-based enterprise” to achieve specific value-based goals for the target patient population, such as improver care quality and reducing costs.
• Providers need to document each value-based enterprise and have personnel in place to keep the enterprise on track to meet its goals, to ensure HHS can check providers’ self-dealing.

For more information on the reformed rules and regulations, CMS created a free resource here: Modernizing and Clarifying the Physician Self-Referral Regulations Final Rule.

Sources: CMS