The Trump administration and Department of Health and Human Services recently proposed changes to the Stark Law and the Federal Anti-Kickback Statute in an effort to ease regulations on health care providers.
Health and Human Services Secretary Alex Azar said in a news release last week that the new rules would loosen antiquated regulations and the burden of compliance, which he said was getting in the way of health providers working together to provide better care for Medicare patients.
Stark Law was enacted in 1989 to ban physicians from referring patients for other medical services if it would financially benefit them. Physicians are currently discouraged from these arrangements because the consequences of not complying with Stark Law regulations are so serious.
“President Trump has promised American patients a health-care system with affordable, personalized care, a system that puts you in control, provides peace of mind and treats you like a human being, not a number. But too often, government regulations have stood in the way of delivering that kind of care,” Azar said.
“Our proposed rules would be an unprecedented opportunity for providers to work together to deliver the kind of high-value, coordinated care that patients deserve.”
The proposals come just over a year after Kalispell Regional Healthcare settled a whistleblower lawsuit for $24 million. The Inter Lake reported in September 2018 that the lawsuit alleged the hospital violated the Stark Law and anti-kickback statutes by charging rates well above the fair market value, which led to an influx in self-referrals that financially benefited some physicians and hospital executives.
It was the largest False Claims Act recovery in state history.
In March 2019, the Inter Lake reported that the hospital had met initial deadlines for improvements to its compliance program. This was the start of a five-year time frame during which the Office of Inspector General for the Department of Health and Human Services will oversee the hospital’s compliance to federal statutes.
But Kalispell Regional, along with the rest of the nation’s health-care providers, will have more freedom to coordinate care for patients if the proposals become law, according to Health and Human Services.
The proposed changes would allow for permanent exceptions to the Stark Law for value-based services, which according to the Center for Medicare and Medicaid Services, will allow for physicians to collaborate and enter into “innovative arrangements” that “would improve quality outcomes, produce health system efficiencies and lower costs (or slow their rate of growth).”
The reforms cannot go forward until after a public comment period of 75 days from when the proposals are submitted to the federal registrar, which will likely happen this week.
Reporter Colin Gaiser can be reached at 758-4439 or at email@example.com