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.
Modernizing the Stark Law
The Digestive Health Physician Association supports the bipartisan 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). The legislation has the full support of 24 physician organizations representing more than 500,000 physicians who care for millions of Medicare patients.
The legislation seeks to eliminate barriers created by the federal physician self-referral prohibitions (Stark Law), which currently inhibit physician practices that are developing advanced alternative payment models (APMs) from rewarding or penalizing physicians for complying with clinical guidelines and treatment pathways designed to improve patient outcomes and/or lower costs with revenue from designated health services.
Specifically, it would provide the U.S. Department of Health and Human Services 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 […]
U.S. Senator Debbie Stabenow (D-MI) visited DHPA member, Huron Gastroenterology, and met with the group’s physicians regarding healthcare issues being debated in the U.S. Congress. DHPA Board member, Dr. Naresh Gunaratnam, who also serves as research director at Huron Gastro, and his colleagues discussed with Sen. Stabenow the importance of preserving the high quality, cost […]
DHPA today filed comments in response to CMS’s proposed rule implementing the Merit-Based Incentive Payment System (MIPS) and Incentives for Alternative Payment Models (APMs). This major proposed rule establishes new ground rules for physician payments under the MACRA legislation passed by Congress last year. MACRA represents a fundamental change in the way physicians are paid […]
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).