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American Association for Physician Leadership
American Association for Physician Leadership

Finalized Changes to Stark & Anti-Kickback Statute Laws

by Jessica L. Bailey-Wheaton, Esq. | Todd Zigrang, MBA, MHA, FACHE, CVA, ASA | Bhagwan Satiani, MD, MBA, DFSVS, FACHE, FACS

July 8, 2021


Summary:

The Centers for Medicare & Medicaid Services and the Office of Inspector General recently issued the highly anticipated final rules to modernize and clarify the Stark Law and the Anti-Kickback Statute. Here’s what it means for physician leaders.



Abstract:

The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) recently issued the highly anticipated final rules to modernize and clarify the Stark Law and the Anti-Kickback Statute. The final rules related to each of these laws seek to establish new exceptions/safe harbors and definitions, and provide additional flexibility to support the current shift in the US healthcare delivery and payment system from volume-based to value-based reimbursement. The significant changes affecting physician practices include fundamental changes in terminology; newly established exceptions/safe harbors for value-based arrangements; lowered regulatory hurdle with a new exception for limited remuneration to a physician; a safe harbor for patient engagement and support; a safe harbor for CMS-sponsored models; eased restrictions related to cybersecurity technology; changes to the group practice rules related to profit distribution; and more.


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Jessica L. Bailey-Wheaton, Esq.

Jessica L. Bailey-Wheaton, Esq., is vice president and general counsel of Health Capital Consultants in St. Louis, Missouri.


Todd Zigrang, MBA, MHA, FACHE, CVA, ASA

Todd Zigrang, MBA, MHA, FACHE, CVA, ASA, is president of Health Capital Consultants in St. Louis, Missouri.


Bhagwan Satiani, MD, MBA, DFSVS, FACHE, FACS

Bhagwan Satiani MD, MBA, FACHE, DFSVS, FACS is a professor of clinical surgery at the Ohio State University Wexner Medical Center, Columbus, Ohio. He blogs at www.savvy-medicine.com . Bhagwan​.Satiani@osumc​.edu

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