Home Health & Hospice Week

Giving free tech to referral sources may be OK, one HHS example says.

Home health is still a Designated Health Service under the Stark Law, but home health agencies and physicians may have a bit more leeway in their arrangements under newly finalized Stark revisions.

Background: In October 2019, the Centers for Medicare & Medicaid Services proposed long-awaited updates to the Physician Self-Referral Law — Stark Law for short — modernizing many of the policies to address technology, value-based care, and compensation. The Stark Law prohibits physician self-referrals to DHS entities including home health agencies. Originally, the agency promised the final rule in August 2020. But then CMS released an extension in the Federal Register that delayed the final rule until later in 021.

Surprise: On Nov. 20, CMS released the Stark Law final rule, which at more than 670 pages is chock full of burden-reducing arrangements and cost-cutting revisions.

Among many changes, the final rule published in the Dec. 2 Federal Register lays out three new Stark Law exceptions for value-based arrangements with varying levels of risk and reward. It also defines a variety of related terms such as value-based enterprise (VBE) and value-based participant.

CMS also outlines the “big three” — fair market value, commercially reasonable, and volume or value standard — in great detail. The final rule clarifies and defines each under the Stark Law while setting parameters for the separate but intertwined requirements related to financial arrangements.

And the rule makes changes to promote better security.

For example: Under the rule, a health system could now furnish cybersecurity technology to physician practices to reduce harm from cyber threats to all their systems, the Department of Health and Human Services offers in its release on the changes.

Nearly all of the final rule changes are effective Jan. 19, 2021. The 191-page rule is at www.govinfo.gov/content/pkg/FR-2020-12-02/pdf/2020-26140.pdf.