Revision of the Stark Law is just one of many factors promoting value-based care | FTI Council

The Department of Health and Human Services released the final rules on November 20, 2020 with changes to the Physician Self-Referral Act (Stark Act) and Anti-Rebound Act (AKS) to facilitate coordination care and value-based care. In this article, we discuss the Stark Law, the AKS and its modifications, as well as its implications. An operational perspective of “net income” is also provided.

Stark Law and Anti-Rebound Status –

The Physician Self-Referral Act, also known as the Stark Act, prohibits physicians from referring patients to “designated health services” that are payable by Medicare or Medicaid to entities with which the physician or an immediate family member the exception applies. Financial relationships include both property and investment interests, as well as compensation arrangements. “Designated health services” include clinical laboratory services, physiotherapy, occupational therapy and ambulatory speech-language pathology services, radiology, EMD and supplies, parenteral and enteral nutrients, prosthetics, prosthetic services. home health, outpatient prescription drugs, and inpatient and outpatient services …

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