Director of CMS signals ‘an inter-agency group’ to be formed with HHS OIG, DOJ, others.
For years, providers have complained that federal statutes known as the Stark laws have impeded their ability to improve the quality and efficiency of their healthcare delivery.
Now those complaints will receive the detailed review they deserve, according to Centers for Medicare and Medicaid Services Administrator Seema Verma.
“We’re going to put together sort of an inter-agency group to start looking at this,” Verma said during an American Hospital Association webinar last week.
AHA President and CEO Rick Pollock said the anti-kickback statutes and Stark laws—which prohibit a physician from referring Medicare and Medicaid patients to entities with whom the physician has financial ties—have made it difficult for hospitals to take advantage of the value-based payment opportunities in which CMS has been investing.
“They both present significant barriers to the implementation of some of these new, innovative models that reward coordination and reward value,” Pollock said during the webinar.
Verma agreed that the Stark laws—which were first introduced 30 years ago by U.S. Rep. Fortney Hillman “Pete” Stark, D-Calif.—have had a tough time keeping up with the times.
“This was developed a long time ago, and the payment systems and sort of how we are operating is different, and we need to sort of bring along some of those regulations and figure out what we can do,” she said.
Certain changes could require an act of Congress, Verma noted.
For the time being, CMS officials will work with representatives with other offices and agencies that have jurisdiction over relevant provisions of the laws, including the Health and Human Services Office of Inspector General, the General Counsel’s Office, and the Department of Justice, Verma said.
“Right now, we’re committed to looking at the issue, responding to the very specific challenges that have been cited by the providers, and we’re committed to working through it.”
A previous version of this story misstated CMS Administrator Seema Verma's title. It has been corrected.
Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.