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Regulatory Sprint to Coordinated Care

The promotion of coordinated care is a top health care policy priority for the federal Government. Federal regulations have been cited as hindering the transition to a health care system that emphasizes value and outcomes over volume of care. The Baker Ober Health Law Team is tracking changes to these regulations.

As part of the federal Government's efforts to promote coordinated and value-based care in the health care industry, it has undertaken an extensive review of federal regulations, including the Stark Physician Self-Referral Law (Stark Law), the Anti-Kickback Statute (AKS), and the Civil Monetary Penalty Law (CMP). The Administration has termed this effort the "Regulatory Sprint to Coordinated Care."

On November 20, 2020, the Department of Health and Human Services (HHS) finalized two major regulations:

  • The Centers for Medicare & Medicaid Services (CMS) issued a final rule to modernize and clarify the Stark Law.
  • The HHS Office of the Inspector General (OIG) issued a final rule to add new safe harbors and to clarify existing safe harbors to the AKS. The final rule also makes changes to the CMP for inducements to beneficiaries.

The Baker Ober Health Law Team has been closely tracking the Administration's "Regulatory Sprint to Coordinated Care." We have prepared several resources (available in the drop-down lists below) to help our clients understand the implications of these changes to long-standing fraud and abuse laws. Please check back frequently for updated materials as we continue to delve into the final regulations and the potential significant impact on the health care industry in the months and years ahead.

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