DHPA and 26 additional physician groups voiced strong support for S.966, the Medicare Care Coordination Improvement Act of 2019, bipartisan legislation that would substantially improve care coordination for patients, improve health outcomes and restrain costs by allowing physicians to participate and succeed in alternative payment models.
The bipartisan bill introduced by Sen. Rob Portman (R-OH) and Sen. Michael Bennet (D-CO), would modernize the “Stark” self-referral law that was enacted nearly 30 years ago and poses barriers to care coordination. The Stark Law prohibits payment arrangements that consider the volume or value of referrals or other business generated by the parties. These prohibitions stifle care delivery innovation by inhibiting practices from incentivizing their physicians to deliver patient care more effectively and efficiently because the practices cannot use resources from designated health services in rewarding or penalizing adherence to clinical guidelines and treatment pathways.
Congress recognized the Stark Law was a barrier to care coordination long ago when it authorized the Secretary at the Department of Health and Human Services (HHS) to waive the self-referral and anti-kickback prohibitions for Accountable Care Organizations. MACRA’s full potential can only be achieved by modernizing this law for physician-led APMs as well.
The Medicare Care Coordination Improvement Act of 2019 will provide CMS with the regulatory authority to create exceptions under the Stark Law for alternative payment models and to remove barriers in the current law to the development and operation of such arrangements.