E/M Coding Alert - 2020 Issue 18
Fraud & Abuse: Don’t Expect the Stark Update Until 2021
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Article Overview
This article is for healthcare compliance, reimbursement, legal, and provider operations audiences tracking federal fraud-and-abuse policy. It reviews the status of CMS and OIG rulemaking related to Stark Law and the Anti-Kickback Statute, summarizes the role of COVID-19 blanket waivers, and highlights why organizations should prepare for post-pandemic financial arrangement compliance.
Why This Topic Matters
Changes to Stark and AKS policies can affect physician relationships, financial arrangements, and compliance risk across healthcare organizations. The article helps readers understand timing, federal agency activity, and the need to plan ahead for the end of temporary pandemic flexibilities.
Article Sections
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Here’s a Rundown of the Stark Revamp Change-Up
This section summarizes the status of CMS rulemaking related to Stark Law and notes the broader federal context for pending fraud-and-abuse policy changes.
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Plan Now for Post-COVID Compliance
This section discusses COVID-19-related blanket waivers, their expected relationship to the public health emergency, and general compliance considerations for organizations preparing for the end of temporary flexibilities.
What You Will Learn
- The current status of federal Stark Law and Anti-Kickback Statute rulemaking
- How COVID-19 blanket waivers fit into broader fraud-and-abuse compliance planning
- Why healthcare organizations may need to review financial relationships before temporary flexibilities end
- Which federal agencies and policy materials are relevant to the issue
Who Should Read This
- Healthcare compliance professionals
- Medical practice administrators
- Provider organizations
- Healthcare attorneys
- Revenue cycle and reimbursement staff
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