In shift to value, providers worry about running afoul of kickback laws. OIG announced it’s seeking ideas on how to fix that

04 Sep 2018 | SOURCE: Fierce Healthcare




The Department of Health and Human Services has released its long-promised request for information on reforming anti-kickback statutes.

The RFI (PDF) was posted to the Federal Register on Monday. The HHS Office of Inspector General is seeking feedback on ways it could adjust the implementation of the law to allow for better growth of value-based care programs.

OIG wants to build new safe harbors or modify existing ones to break down barriers to care coordination while still protecting against fraud and abuse, it said in the document.

“Through internal discussion and with the benefit of facts and information received from external stakeholders, OIG has identified the broad reach of the anti-kickback statute and beneficiary inducements [civil monetary penalty] as a potential impediment to beneficial arrangements that would advance coordinated care,” OIG said.

The agency first said the RFI was coming in mid-July, in congressional testimony from Deputy Secretary Eric Hargan. Changes to the way it enforces anti-kickback statutes are part of HHS’ “regulatory sprint” toward more coordinated care, which Hargan is spearheading.

Donald White, a spokesperson for OIG, told FierceHealthcare the RFI offers a “really great opportunity” for providers and other stakeholders to voice opinions that could direct the agency’s goals.

Hargan told legislators it’s important to HHS to ensure anti-kickback protections “aren’t strangling innovation and new models of care that will be for the benefit of the American people.”

The document was released as the comment period ended Friday for the Centers for Medicare & Medicaid Services’ request for information on potential changes to the enforcement of the Stark Law—another part of the agency’s “regulatory sprint.”

CMS Administrator Seema Verma said the Stark Law in its current form could hinder the expansion of value-based care.

“To achieve a truly value-based, patient-centered healthcare system, doctors and other providers need to work together with patients,” Verma said. “Many of the recent statutory and regulatory changes to payment models are intended to help incentivize value-based care and drive the Medicare system to greater value and quality.”

Comments on OIG’s request can be submitted for the next 60 days.

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