CMS: Reform Physician Self-Referral Law
ASPS joined the Alliance of Specialty Medicine in submitting feedback to Seema Verma, Administrator of the Centers of Medicare and Medicaid Services (CMS), on the physician self-referral law, commonly referred to as Stark Law. The Society along with the Alliance urged CMS to exempt all participants of alternative models of care and delivery who bear financial risk from the Stark regulations.
ASPS expressed concern with the shortage of specialty-focused alternative payment models (APMs), making it increasingly difficult for specialists to fully participate in the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Unfortunately, specialists face additional burdens establishing APMs because hospital and health system administrators often raise concerns about potential Stark Law violations.
ASPS recommended that CMS fully utilize the Physician-Focused Payment Model Technical Advisory Committee (PTAC), responsible for reviewing specialty-driven care models, to help increase specialty engagement. Despite numerous model recommendations by the committee, the Secretary has failed to implement any specialty models. The Society urged CMS to initiate the testing and implementation of specialty-driven care models reviewed by PTAC as soon as possible.
While ASPS understands the Agency's efforts to deter Medicare program abuse, the current system puts specialists at a serious disadvantage and discourages them from transitioning to alternative models of care and delivery that benefit the Medicare program and beneficiaries. ASPS will continue to work with the specialty medicine community to monitor this issue.