CMS has finalized sweeping changes to its federal self-referral policies, updating the “Stark Law” with new exceptions and protections for healthcare providers. The news has been years in the making, with CMS signaling that these policies were a high-priority target for modernization since 2017.
The updated regulations were finalized on Friday, Nov. 20. According to CMS, the changes will lead to significant reductions in paperwork and encourage providers to pursue collaborations focused on the delivery of high-quality care.
“That sound you hear is the mingled cheers and exclamations of relief from doctors and other health care professionals across the county as we lift the weight of our punishing bureaucracy from their backs,” Seema Verma, CMS administrator, said in a statement.
Some of the updates include:
- Exceptions designed to “permit physicians and other healthcare providers to design and enter into value-based arrangements without fear that legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the physician self-referral law”—and a thorough explanation of those exceptions that can physicians can easily reference.
- Protections for “non-abusive, beneficial arrangements” that will now be allowed in both fee-for-service and value-based payment systems.
- A reduction in the administrative responsibilities associated with Stark law compliance.
According to CMS, the patient protections built into the prior federal self-referral policies remain in place. This should still “clearly prohibit” referrals that only exist to benefit the provider.
More information is available here, and the full rule is scheduled to be online by Dec. 2.
A happy day for cardiologists
Cardiologists—and physicians from many other specialties, for that matter—have been hoping for such a shift for quite some time. Industry leaders, including representatives from the American College of Cardiology and other specialty groups, have been unhappy with the Stark Law for years.
Click here for more on how these self-referral regulations have been impacting cardiologists during the industry’s ongoing shift toward value-based care.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.