Changes to the physician self-referral “Stark” law

On Friday, Nov. 20, the Centers for Medicare & Medicaid Services announced changes to the Physician Self-Referral Law, also known as the “Stark Law,” as well as revisions under the Anti-Kickback Statute. Historically, the Stark Law has prohibited physicians from making referrals to entities for certain healthcare services paid by Medicare if the physician has a financial relationship with the entity. MGMA and other stakeholder groups have long argued these rules impede the nation’s transition to value-based reimbursement. The new Stark Law rule finalizes many of the proposed policies from the notice of proposed rulemaking issued in October 2019, including:

• Creating exceptions for value-based arrangements that permit physicians and other providers to design and enter into value-based arrangements without violating the physician self-referral law;
• Offering additional guidance on key requirements of existing exceptions to the physician self-referral law; and
• Providing protection for non-abusive, beneficial arrangements that apply regardless of whether the parties operate in a fee-for-service or value-based payment system, such as donations of cybersecurity technology that safeguard the integrity of the healthcare ecosystem.