Pulished in Healio The bipartisan legislation, “The Medicare Care Coordination Improvement Act of 2017,” was recently introduced by the Senate to modernize the Stark Law and eliminate the barriers it poses to care coordination. Read More >>
Modernizing the Stark Law
As our healthcare system shifts from a fee-for-service model to value-based care, two payment structures incentivized by the Medicare Access and CHIP Reauthorization Act (MACRA) are the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
MIPS is a modified fee-for-service system in which a portion of physician payments will be based on quality, resource use across the entire Medicare program, meaningful use of electronic health records, and clinical practice improvements. APMs are arrangements like an Accountable Care Organization or bundled payment model that requires physicians to take on risk and bases compensation on quality. As such, physicians will need to coordinate care, control volume and work as teams.
The outdated Stark Law makes it difficult for independent GI practices to develop and engage in APMs and should be modernized to provide clarity and flexibility for participation in value-based payment models.
DHPA strongly supports the Medicare Care Coordination Improvement Act of 2017 (H.R. 4206, S. 2051), which promotes care coordination and will enable physicians to participate more fully in the value-based payment models incentivized by the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (Pub. L. 114-10, enacted April 16, 2015). H.R. 4206, was […]
Published in POLITICO Stark Law bill: Sens. Rob Portman and Michael Bennet introduced a bill Wednesday to adapt Medicare’s anti-kickback laws. The regulations are intended to crack down on physician conflicts of interest in making referrals and purchasing services, but critics believe the laws need reform in a value-based payment era. Portman and Bennet’s bill, […]
The Medicare Care Coordination Improvement Act would remove barriers to physician practice participation in APMs. Specifically, it would provide CMS the same authority to waive restrictions in the Stark Law and Anti-Kickback Statute for physicians seeking to develop and operate APMs as was provided to Accountable Care Organizations in the Affordable Care Act. It would allow physician practices to incentivize practitioners to provide high quality care while alternative payment models are under development and in operation.
DHPA has submitted comments on the importance of modernizing the federal physician self-referral law (Stark Law) to the U.S. House Ways and Means Health Subcommittee’s Medicare Red Tape Relief Project, an initiative aimed at “delivering relief from the regulations and mandates that impede innovation, drive up costs, and ultimately stand in the way of delivering […]