In this review: Modernizing and Clarifying the Physician Self-Referral Regulations (final rule); Revisions to Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements (final rule)
Effective date: Jan. 19, 2021, for all except an amendment to the self-referral regulations that address group physician practices [42 CFR 411.352(i)].
The big picture: Two final rules try to bring self-referral and safe harbors provisions up to date to reflect value-based arrangements, but they don't address troubling loopholes of in-office ancillary services including physical therapy. After decades of mostly not touching regulations around the law that bars physicians from referring Medicare patients to services in which the physician has a financial interest — the so-called "Stark Law" — the U.S. Department of Health and Human Services has finalized changes that it believes will help accommodate value-based arrangements between a physician and an entity that participates in the same "value-based enterprise." The result is a mixed bag that ignores the loophole, opposed by APTA, that weakens the self-referral law and creates an uneven playing field for physical therapists.