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HHS and CMS are Considering Stark Law Reform


The ‘Stark Law’ refers to a collection of federal regulations that prohibit self-referral by physicians. Medical practice owners and operators must be aware of these regulations. Stark Law violations can come with severe penalties, potentially including denial of payment, heavy fines, and a permanent exclusion from participating in federally funded health programs (Medicare & Medicaid).

In recent years, there have been serious talks about reforming the Stark regulations. Reform is now beginning to pick up speed. Earlier this summer, the Trump Administration made it clear that action is closer than ever. In June, the Centers for Medicare & Medicaid Services (CMS) issued a public request for information on ideas and policy changes that could help to address the regulatory burden caused by the Stark Law.

Coordinated Care is Desired; But the Stark Law Poses Some Obstacles  

Coordinated medical care has become one of the top trends in Washington. Many agencies are trying to move the United States medical care system away from the traditional fee-for-service model and over to a so-called value-based system that is far more focused on overall coordination between healthcare providers. Whether or not this is advisable for our healthcare system is a deeply complex question. Though, one thing is clear: in its current form, the Stark Law poses real challenges to coordinated care. From reviewing the request from public comment from CMS/HHS, we can see that there are certain areas that the agencies are focused on in potential Stark Law reform. CMS is looking for medical professionals with experience and observations on:

  • The possibility of expanding the exceptions to the Stark Law to permit or encourage the implementation of alternative payment models; and
  • Possible reforms the Stark Law regulations that would help to ease the burden on physicians.

CMS Administrator Seema Verma has put together inter-governmental panels on this issue and has stated that her agency’s proposed Stark Law changes are expected to be released by the end of this year.

The Regulatory Process is Long and Complicated 

As medical professionals know well, regulatory reform can move at a slow, sometimes gradual pace. It is far from certain that the Stark Law will be reformed at all, and it is not clear as to what exactly the future reforms will look like. Though, there is strong evidence that a bipartisan consensus is developing that real changes are needed to the Stark Law. At Pike & Lustig, LLP, our Miami physician practice management attorneys represent professionals in handling a wide range of Stark Law issues. As always, our law firm will keep a close watch on any relevant regulatory changes. 

Get Help From a South Florida Stark Law Attorney Today

At Pike & Lustig, LLP, our Miami business law attorneys have extensive experience serving medical professionals and medical practices. This includes handling Stark Law matters. To learn more about what our Florida business lawyers can do for you, please contact us today for a fully private consultation. With offices in Miami and West Palm Beach, we represent medical practices all around the region.




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