CMS seeks provider input on updating Stark Law

The nearly 30-year-old Stark Law could be due for an overhaul, according to CMS. The agency is requesting public feedback on how to streamline the law’s administrative requirements and retool it to better fit with modern alternative payment models and value-based care.

The Stark Law is an anti-kickback law that was designed to discourage and penalize providers for healthcare decisions driven by financial motives. The law prohibits physicians from making referrals for certain services, payable by Medicare, to an organization that the physician or an immediate family member has a financial relationship. In addition, the law prohibits the organizations from filing claims with Medicare, another payer, or an individual for those services. The law does allow for some exceptions and, even in its current form, allows HHS to create regulatory exceptions.

Recently, CMS and other payers have moved toward value-based care and alternative payment models, such as the Bundled Payments for Care Improvement Advanced model. These programs generally hinge on referrals between physicians and other organizations that, due to the nature of the program, may have a financial relationship.

CMS is seeking suggestions on how to update the Stark Law. The agency is particularly interested in comments that discuss ways it can reduce the regulatory burden of the law and bring it in line with new value-based care models. A request for information was published in the Federal Register on June 26. Comments may be submitted electronically, by regular mail, or by express or overnight mail. All comments are due by August 24.