Anti-Kickback, Doctor Self-Referral Law Waivers for ACOs Extended
Last week, CMS and HHS' Office of Inspector General released an interim final rule that extended for at least a year waivers to the federal anti-kickback and physician self-referral laws for accountable care organizations participating in the Medicare Shared Savings Program, Modern Healthcare reports.
The waivers, which were set to expire in November, will now remain in effect through Nov. 2, 2015.
Background
Waivers to the anti-kickback and physician self-referral laws -- or Stark laws -- have been in place for nearly three years. They are intended to give ACOs more flexibility in coordinating care as the health care industry transitions from a fee-for-service reimbursement model to one centered on quality.
CMS, HHS OIG Detail Reasons for Extension
The interim final rule stated that the waivers were extended for several reasons, including:
- CMS' development of its own rule for the MSSP; and
- To give CMS and OIG additional time to collect stakeholder feedback on the effectiveness of the waivers.
The rule also noted that letting the waivers expire would have created "legal uncertainty" and disrupted "ongoing business plans or operations" for some ACOs in the MSSP.
Reaction
Joe Lynch -- a partner at the law firm King & Spalding -- said he was not surprised about the extension, noting that the MSSP "would have immediately collapsed" without the waivers.
However, some experts said an extension of the waivers is not enough. For example, Center for Healthcare Quality and Payment Reform President and CEO Harold Miller said it was "troubling" that the waiver regulations were only extended, rather than finalized. He added that uncertainty of the waivers could deter providers from joining the program (Schencker, Modern Healthcare, 10/17).
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