Compliance Perspectives: Changes to the Physician Self-Referral and Anti-Kickback Rules

Health Care Compliance Association (HCCA)
Contact
As healthcare moves increasingly from fee-for-service model to one focused on outcomes and value-based payments, the traditional fraud and abuse laws, such as the Anti-Kickback Statute and the Stark Law, pose obstacles to this transition. As a result, the Department of Health and Human Services (HHS) issued a proposed rule to make changes to these statutes’ regulations as part of its Regulatory Sprint to Coordinated Care. These changes both address facilitating the transition to value-based payments and also reduce regulatory burden See more +
As healthcare moves increasingly from fee-for-service model to one focused on outcomes and value-based payments, the traditional fraud and abuse laws, such as the Anti-Kickback Statute and the Stark Law, pose obstacles to this transition. As a result, the Department of Health and Human Services (HHS) issued a proposed rule to make changes to these statutes’ regulations as part of its Regulatory Sprint to Coordinated Care. These changes both address facilitating the transition to value-based payments and also reduce regulatory burden by proposing new or amending safe harbors and exceptions. The Stark Law proposed rule also includes new or revised definitions of key terms, such as fair market value, the “volume or value of referrals,” and commercial reasonableness.

In this podcast, Katherine Bowles, a registered nurse and healthcare attorney at Nelson Hardiman and Tony Maida, a partner at McDermott Will & Emery, explain these proposed changes and how to consider preparing for a final rule. This preparation could include exploring potential partnerships to create a value-based enterprise.

Even if the proposed rules are finalized, compliance with the Anti-Kickback Statute and Stark Law will remain an important part of an organization’s compliance program. The panelists discuss ways for compliance programs to address these issues, such as having a sound approval process and monitoring contract performance.

Finally, our panelists also discuss how the COVID-19 pandemic has impacted compliance with these laws, including the rise of telemedicine and the Stark waivers and Anti-Kickback policy statements.

Listen in to learn more.

More information about this podcast:

Compliance Perspectives Podcasts are published weekly. To listen to more podcasts on compliance and ethics topics, visit:

https://complianceandethics.org/category/podcasts

In addition,The Compliance and Ethics Blog is updated frequently. Visit the blog to read more posts on compliance and ethics topics:

https://complianceandethics.org See less -

Embed
Copy

Written by:

Health Care Compliance Association (HCCA)
Contact
more
less

Health Care Compliance Association (HCCA) on:

Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
- hide
- hide

This website uses cookies to improve user experience, track anonymous site usage, store authorization tokens and permit sharing on social media networks. By continuing to browse this website you accept the use of cookies. Click here to read more about how we use cookies.