Dear Representatives Bucshon, Ruiz, Marchant and Kind:
We are writing to convey our strong support for H.R. 4206, “The Medicare Care Coordination
Improvement Act of 2017.” Your legislation would substantially improve care coordination for
patients, improve health outcomes and restrain costs by allowing physicians to participate and
succeed in alternative payment models.
The bill would modernize the “Stark” self-referral law that was enacted nearly 30 years ago and
pose barriers to care coordination. The Stark Law prohibits payment arrangements that consider
the volume or value of referrals or other business generated by the parties. These prohibitions
stifle care delivery innovation by inhibiting practices from incentivizing their physicians to deliver
patient care more effectively and efficiently because the practices cannot use resources from
designated health services in rewarding or penalizing adherence to clinical guidelines and
treatment pathways.
Congress recognized the Stark Law was a barrier to care coordination long ago when it authorized
the Secretary at the Department of Health and Human Services (HHS) to waive the self-referral and
anti-kickback prohibitions for Accountable Care Organizations. MACRA’s full potential can only be
achieved by modernizing this law for physician-led APMs as well.
“The Medicare Care Coordination Improvement Act of 2017” will provide CMS with the regulatory
authority to create exceptions under the Stark Law for alternative payment models and to remove
barriers in the current law to the development and operation of such arrangements. Specifically,
the bill would
- Provide HHS the same authority to waive the prohibitions in the Stark Law and associated fraud
and abuse laws for physicians seeking to develop and opera
…
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