The Trump administration plans to form a group with representatives from CMS, HHS’ Office of Inspector General, HHS’ General Counsel and the Department of Justice to look at the Stark Law and determine ways to potentially remove regulatory barriers.
CMS Administrator Seema Verma said providers are asking for the agency to reduce the burden of the regulations, in particular to allow exceptions to the anti-kickback law for alternative payment models.
She said revamping the regulations could also help quicken the move from fee-for-service to value-based payments, though she acknowledged Congress may need to step in to remove barriers to such care.
The CMS chief made the comments on a webcast with officials from the American Hospital Association this week.
"I think that Stark was developed a long time ago ... and the payment systems and sort of how we are operating is different, and we have to bring along those regulations and see what we can do," Verma said. "I'm not sure that this isn't going to require some congressional intervention as well. Right now we are committed to looking at the issue, responding to the very specific challenges cited by the providers and are working through it."
The Trump administration is far from the first in Washington to seek to revamp the rules. The Senate passed a bill in July, “Medicare Part B Improvement Act of 2017,” which included changes to the Stark Law.
The House also has a bill that would change the Stark Law. The House Medicare Care Coordination Improvement Act of 2017 would give the HHS Secretary the option to allow exceptions for alternative payment models and allow the HHS Secretary to determine ways in which some compensation arrangements could bypass the law.
Health leaders have been pushing to revise the anti-kickback law for years, especially in light of changes to physician compensation, such as the move to value-based contracts.
Stark Law opponents say the law prohibits doctors from referring Medicare patients to other healthcare entities if they have a financial relationship.
It also creates barriers for providers to move into value-based care systems, by not allowing hospitals to pay providers more compensation if they meet quality measures compared to their peers.
Both the CMS and payers are pushing providers to move into value-based care, which they believe will cut costs and improve outcomes.
The Trump administration touts its regulation-cutting agenda, and with Republicans controlling the White House and both houses of Congress, the chances for changes to the Stark Law may be rising.