Stark special rules on compensation:Analyzing the New Compensation Rules under Stark Law
hubbleauthorThe Stark Law, also known as the Physician Self-Revenue Prohibition, is a United States federal law that aims to prevent potential conflicts of interest in healthcare transactions. The law prohibits hospitals and other healthcare providers from billing Medicare or any other government health program for any compensation, including financial or in-kind benefits, that is directly or indirectly related to the referral of patients for certain designated healthcare services. This article will discuss the recent updates to the Stark Law compensation rules and their implications for healthcare providers and stakeholders.
Background
The Stark Law was originally enacted in 1986 and has been regularly amended and interpreted by the US Department of Health and Human Services (HHS) and the US Department of Justice (DOJ). The law applies to all healthcare providers that receive payments from Medicare, Medicaid, or any other government health program. The Stark Law's primary goal is to ensure that healthcare providers make medical decisions based on the best interests of their patients, rather than on their own financial interests.
Compensation Rules Update
In November 2020, the Trump administration issued a final rule amendment to the Stark Law's compensation rules. The updated rule, which will become effective on January 19, 2021, aims to streamline and simplify the current compensation rules, making it easier for healthcare providers to comply with the law. Some of the key changes in the updated rule include:
1. Expanded Definitions of Designated Healthcare Services (DHS): The updated rule expands the definition of DHS to include certain services provided by non-physician practitioners, such as podiatrists, dentists, and psychological professionals. This expansion is intended to reduce the number of services subject to the Stark Law's compensation restrictions.
2. Modified Financial Arrangements: The updated rule modifies the definition of financial arrangements, excluding certain loan transactions from the scope of the Stark Law's compensation restrictions. This exemption is intended to promote access to healthcare financing for patients and providers.
3. New Safe Harbors: The updated rule introduces new safe harbors for certain types of compensation arrangements, such as non-competition agreements and administrative fees. These safe harbors provide guidance on the types of compensation arrangements that are deemed permissible under the Stark Law.
4. Simplified Compensation Rules for Certain Arrangements: The updated rule simplifies the compensation rules for certain arrangements, such as administrative fees and certain medical staff memberships. This simplification is intended to make it easier for healthcare providers to comply with the Stark Law's compensation restrictions.
Implications for Healthcare Providers and Stakeholders
The updated Stark Law compensation rules should provide healthcare providers and stakeholders with more clarity and flexibility in designing and implementing compensation arrangements. However, the new rules also introduce new complexities and risks that require ongoing compliance monitoring and assessment. Healthcare providers should carefully review the updated rule and consider consulting with legal and regulatory advisors to ensure compliance with the new regulations.
The Stark Law is a crucial piece of healthcare legislation that aims to prevent potential conflicts of interest in healthcare transactions. The recent updates to the law's compensation rules are intended to streamline and simplify the current rules, making it easier for healthcare providers to comply with the law. Healthcare providers and stakeholders should be aware of these updates and carefully review the updated rule to ensure compliance with the new regulations.