Updates in Stark Law: What It Means for QPP MIPS?

CMS (Centers for Medicare and Medicaid Services) has revamped the Stark Law for healthcare service providers.

The upgraded law will have an impact on the volume and quality of healthcare services. Especially, QPP MIPS eligible clinicians can take notes and design strategies to improve patient satisfaction.

For those of you, who do not know about the Stark Law, here is its definition!

What is Stark Law?

This law prohibits physicians from self-referral, particularly in a situation, when a physician has a financial relationship with a patient and refers to another entity for the provision of designated health services (DHS).

The new laws will also influence the QPP MIPS quality score via a transparent referral process. Without a doubt, it is a great step towards an altogether progressive healthcare system.

Proposed Changes

• CMS proposed changes that allow exceptions for/among certain physicians.
• The final proposed rule also applies exceptions in some cases when a physician receives reimbursement for items or services from another clinician.
• CMS also proposed flexibilities for the funds or donations extended to the cybersecurity technology and services.
• Moreover, the existing exceptions for the EHR (Electronic Healthcare Records) data, products, and services are also modified.
• The update in the Stark Law is expected to be effective from next year January 19, 2021.

The Stark Law, since its provision in 1989 was the same, and there were no updates since then. CMS says that these modifications are significant and will change the referral scenario in the healthcare industry.

Conclusion

The new changes strive to encourage clinicians to adopt quality-based healthcare practices as specified by the QPP MIPS without fearing Stark Law violations.

The exceptions are introduced to facilitate the reimbursement process and to improve coordination among different stakeholders in a legitimate manner.