decisionhealth Newsletters, Part B News - 2019 Issue 10 (October)
CMS, OIG propose new safe harbors, exceptions to free up value-based care
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Article Overview
This article reviews proposed federal payment and compliance changes aimed at reducing barriers to value-based care. It covers CMS and OIG proposals, the regulatory frameworks involved, and the broad categories of new or revised exceptions, safe harbors, and definitions that may affect physicians, hospitals, and other providers. It is relevant to compliance staff, revenue cycle teams, physician practices, hospitals, and anyone tracking federal healthcare fraud-and-abuse policy.
Why This Topic Matters
The proposals could change how providers structure value-based arrangements and related financial relationships. Understanding the scope of the changes helps organizations monitor compliance, comment on proposed rules, and prepare for future operational adjustments.
Article Sections
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Regulatory Sprint to Coordinated Care
Introduces the federal initiative behind the proposed regulatory changes and explains the broader move away from fee-for-service payment models. It frames the policy context for the rest of the article.
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OIG proposed safe harbors under the anti-kickback statute
Summarizes the types of new and revised OIG safe harbor concepts being proposed. It discusses the general compliance framework and the kinds of arrangements the agency is trying to address.
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CMS proposed Stark Law exceptions and clarifications
Reviews the companion CMS proposals under the physician self-referral rules. It outlines the categories of exceptions, revised definitions, and related rule changes under consideration.
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Comment period and next steps
Notes the public comment process and the timeline for feedback on the proposed rules. It provides the article's closing procedural information.
What You Will Learn
- The federal initiatives driving the proposed value-based care changes
- The general categories of AKS safe harbor proposals under review
- The general categories of Stark Law exceptions and definition changes under review
- Which provider groups and compliance audiences may be affected
- The comment-process timeline for the proposed rules
Who Should Read This
- Physicians
- Hospitals
- Compliance officers
- Healthcare attorneys
- Revenue cycle staff
- Value-based care stakeholders
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