On Dec 2, 2020, the regulatory updates to the Physician Self-Referral and Anti-Kickback Statute (AKS) were published in the Federal Register. Health and Human Services (HHS) and sub-agencies are proposing significant updates to the fraud and abuse programs. There is a 1-year period (until January 2022) before the majority of provisions of the final rule become effective.

The Stark Regulations saw significant updates and clarifications. In reviewing the Stark and AKS, you’ll note similar changes between them. The most apparent is the Safe Harbors for value-based care arrangements. There had to be collaboration at the sub regulatory agency level the way some of these read!

Providers and their compliance consiglieres must examine relationship(s) with referral sources. In the coming weeks I’ll break down aspects of the complex rules:

1. New Value-Based Arrangements Exceptions (Stark) and Safe Harbors (AKS)
2. Stark Law Rules on Group Practice Compensation Methodologies
3. Changes to Stark Law Terminology – 3 Notable Changes
4. Clarifications/Revisions of Stark Concepts
5. Exceptions and Safe Harbors Stark and AKS
6. Other “new” Exceptions (Stark) and Safe Harbors (AKS)

By Sean M. Weiss, Partner, Vice President, and Chief Compliance Officer

Sean M. Weiss is a Partner and Chief Compliance Officer for DoctorsManagement, LLC. Sean provides strategic litigation defense services and a host of regulatory compliance services for clients nationally.

Learn more about Sean’s expertise at www.thecomplianceguy.com.

What to do next…

1. If you need help with an audit appeal or regulatory compliance concern, contact us at (800) 635-4040 or via email at [email protected].
2. Read more about our: Total Compliance Solution

Why do thousands of providers trust DoctorsManagement to help improve their compliance programs and the health of their business?

Experienced compliance professionals. Our compliance services are structured by a chief compliance officer and supported by a team that includes physicians, attorneys and a team of experienced auditors. The team has many decades of combined experience helping protect the interests of physicians and the organizations they serve.

Quality of coders and auditors. Our US-based auditors receive ongoing training and support from our education division, NAMAS (National Alliance of Medical Auditing Specialists). All team members possess over 15 years of experience and hold both the Certified Professional Coder (CPC®) as well as the Certified Professional Medical Auditor (CPMA®) credentials.

Proprietary risk-assessment technology – our auditing team uses ComplianceRiskAnalyzer(CRA)®, a sophisticated analytics solution that assesses critical risk areas. It enables our auditors to precisely select encounters that pose the greatest risk of triggering an audit so that they can be reviewed and the risk can be mitigated.

Synergy – DoctorsManagement is a full-service healthcare consultancy firm. The many departments within our firm work together to help clients rise above the complexities faced by today’s healthcare professionals. As a result, you receive quality solutions from a team of individuals who are current on every aspect of the business of medicine.