Seeking to remove unnecessary government obstacles to care coordination, the Centers for Medicare & Medicaid Services (CMS) has issued a Request for Information (RFI) to help identify aspects of the physician self-referral law (Stark Law) that may be acting as potential barriers to coordinated care and additional public comment on possible new approaches.
Stark Law Overview
The Stark Law is intended to separate physicians’ health care decision making from their own financial interests in other health care providers and suppliers. The Stark Law (1) prohibits physicians from making referrals for certain designated health services (DHS) payable by Medicare to an entity with which they (or an immediate family member) have a financial relationship, unless an exception applies; and (2) prohibits the entity from filing claims with Medicare for such services, unless an exception applies. CMS has authority to promulgate regulatory exceptions for financial relationships that do not pose a risk of program or patient abuse.
CMS’s RFI Seeks Comment on the Following:
Respondents are encouraged to provide complete but concise responses. Respondents may submit comments addressing one or more of the questions posed in the RFI. All submissions must clearly identify and provide contact information for the respondent to be considered.
The full CMS RFI regarding the Stark Law was published in the Federal Register on June 25, 2018 and may be viewed at https://www.federalregister.gov/documents/2018/06/25/2018-13529/medicare-program-request-for-information-regarding-the-physician-self-referral-law. Comments on this RFI may be submitted at https://www.regulations.gov/document?D=CMS-2018-0082-0001 or sent by mail to the addresses specified in the RFI. Refer to file code CMS-1720-NC when commenting. Comments must be received no later than 5:00 PM on August 24, 2018.
With this RFI, physicians have an opportunity to explain to CMS the difficulties that they face in complying with the Stark Law while providing coordinated care to their patients, as well as suggest alternatives or updates to facilitate such practice.
Should you or your organization have questions about the Stark Law or need assistance in commenting on the RFI, please contact Peter Mellette, Harrison Gibbs, or Nathan Mortier at Mellette PC at (757) 259-9200.
This Client Advisory is for general education purposes only. It is not intended to provide legal advice specific to any situation you may have. Individuals desiring legal advice should consult legal counsel for up-to-date and fact-specific advice.