Earlier this week, the Senate Finance Committee held a hearing to discuss the Stark Law, an endeavor that saw medical professionals, health law attorneys and business executives from across the U.S. voice similar concerns that the law has become needlessly complex and wholly unnecessary.
For those unfamiliar with the Stark Law, it essentially prohibits physicians from referring patients to providers with whom they have existing financial connections and/or facilities where they have ownership interests (i.e., imaging centers and labs). Its original purpose was to remove financial considerations from the medical decision-making process, and, by extension, curb Medicaid and Medicare overutilization.
Why is the Stark Law so reviled in the health care sector?
According to those who testified at the hearing, the law has become too confusing for providers to follow and, more significantly, unnecessary given that the healthcare system is continuing to evolve from the longstanding fee-for-service-based payment model to a value-based payment model which encourages greater care coordination.
What exactly does the health care sector want to see done?
While those who testified at Tuesday's hearing called for the complete repeal of the Stark Law, they also indicated that amending its more rigid provisions would also go a long way. For instance, several lobbied for the removal of its prohibition on compensation arrangements and its exception for in-office ancillary services.
Why are appeals being made to Congress?
The Centers for Medicare and Medicaid Services lacks the authority to create regulatory exceptions to the Stark Law or otherwise amend it to facilitate the move toward value-based payment models.
Is Congress amenable to changing the Stark Law?
Early indications are that it might be, as members of the Finance Committee from both side of the aisle expressed frustration with it.
Indeed, Chairman Orrin Hatch (R-UT), who referred to the Stark Law as "the embodiment of good intentions muddled with complex execution,” expressed hope that the committee would be able to introduce a measure to reform it by the end of the year, focusing on things like its overall lack of clarity and steep penalties for technical violations.
Stay tuned for updates …
Consider speaking with a skilled legal professional as soon as possible if you are a medical provider who has been accused of any sort of misconduct by state or federal officials.