Over the last several years, there have been attempts to curb the ability of independent physician practices to offer clinically appropriate ancillary services to their patients. These attempts have focused on curbing or eliminating the In-Office Ancillary Services Exception (IOASE), which permits physicians who are members of a group practice to refer a patient for designated health services (DHS) without violating the Stark Law.
In the more than 25 years since its passage, the law has become one of the most significant sources of regulatory burden on physicians and, ultimately, for Medicare beneficiaries. These restrictions make it more difficult for independent physician practices to coordinate care, creating a competitive advantage for large hospital systems.
Given that the system is rapidly transitioning away from fee-for-service payment, the law is outdated.
What are LUGPA’s Goals?
Modernization of the Stark Law would empower physician practices to engage in value-based care, allowing them to take on risks and improve clinical outcomes through Alternative Payment Models (APMs). LUGPA supports enactment of legislation that would permit independent practices to test and participate in APMs without the current prohibitions.
In addition, LUGPA will continue to defend the In-Office Ancillary Service Exemption, which allows the integrated delivery of care by physician practices under the fee-for service system, including for radiation therapy, labs and advanced imaging by physician practices.
LUGPA’s Actions and Resources
Changes Needed to Stark Law, House Members Told – July 18, 2018
Update the Stark law now, HHS and providers tell Congress – July 17, 2018
Supporting the Independent Practice in a Value-Based Care System – July 16, 2018
LUGPA Supports CMS’ Efforts to Modernize Stark Law – June 20, 2018
LUGPA Comments to Congress Re: Modernizing Stark Law – January 29, 2016