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CMS Seeks Stakeholder Input on Stark Law

The Centers for Medicare and Medicaid Services (CMS) is seeking input from the public on how the physician self-referral law, or Stark Law, may be affecting the coordination of care for federally funded patients.

According to CMS, revising the Stark Law is an area of focus for the Trump administration because alternative payment models and innovations that may help to move from fee-for-service to value-based care could be found in violation of the law, or otherwise not fit into one of the law’s narrow exceptions.

CMS says that the Stark Law, in place since 1989, “is intended to disconnect a physician’s healthcare decision-making from his or her financial interests in other healthcare providers and suppliers.” However, CMS says it is “aware of the effect the physician self-referral law may have on parties participating or considering participation in integrated delivery models, alternative payment models, and arrangements to incent improvements in outcomes and reductions in cost.”

The agency notes that President Trump’s fiscal year 2019 budget contains a legislative proposal to carve out an exception to the Stark Law and allow greater room for alternative payment models. CMS now is seeking comments from all stakeholders about how the Stark Law affects financial relationships, how it might be inhibiting the growth of new models, and how it could be improved.

Robert B. Vogel, MD, JD
Retinal Ophthalmologist at Piedmont Eye Center, Lynchburg VA;
Attorney, Overbey Hawkins & Wright, PLLS, Lynchburg, VA;
Adjunct Professor, Humanities and Bioethics, Liberty University School of Medicine, Lynchburg, VA.