CMS Proposed Rule Adds Exceptions to Stark Law and Provides Additional Guidance and Clarification

We recently outlined the significant proposed changes to the Stark Law that the Centers for Medicare & Medicaid Services (CMS) released on October 9.  The analysis was written for the American Health Lawyers Association’s (AHLA) Fraud and Abuse Practice Group and co-authored by Dickinson Wright attorney Rose Willis. In the article, the authors summarized the Proposed Rule, including:

1. Changes related to a value-based care delivery model – With the ongoing shift from the traditional fee-for-service model to value-based payment and delivery model, the Proposed Rule addresses three new exceptions to the Stark Law focused on the value-based model.
2. Guidance on changes in terminology – The Proposed Rule provides new insight on terminology and concepts covered by the Stark Law to attempt to provide clarity to areas open to interpretation.
3. Changes to the scope and application of the law – Upon re-examination, the Proposed Rule added, deleted and revised a number of exceptions to the Stark Law to ensure the original interpretations and intent remained true.

The full article, “CMS Proposed Rule Adds Exceptions to Stark Law and Provides Additional Guidance and Clarification,” was published by AHLA’s Fraud and Abuse Practice Group on October 11, 2019.