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Outlook 2017: New Year May Bring Stark Reform, ACA Repeal, Heavy Dose of Uncertainty

Posted in Fraud and Abuse, Legislation and Public Policy, Medicare and Medicaid, Reimbursement Matters, White Collar

Eric Fader’s comments appeared in a January 4 article entitled “Outlook 2017: New Year May Bring Stark Reform, ACA Repeal, Heavy Dose of Uncertainty,” published in Bloomberg BNA’s Health Care Fraud Report. In the article, Eric discussed his views on the Stark Law self-referral disclosure protocol, currently in flux due to changes proposed in 2016 by the Centers for Medicare & Medicaid Services (CMS).

Although the protocol got off to a great start in 2010, CMS soon fell behind in processing submissions and settlements, and the program ground to a halt in 2016. Eric told Bloomberg BNA that it should still make sense for providers to self-disclose Stark Law violations in 2017 because no matter what changes are ultimately put into effect, the protocol will still offer the possibility of lower repayment amounts.

Similarly, most providers would benefit from self-disclosing potential Anti-Kickback Statute violations to the Department of Health and Human Services’ Office of Inspector General under a separate program, Eric said. In both the CMS and OIG self-disclosure programs, technical violations can be settled at little cost, and self-disclosure may allow some providers to escape exclusion from the Medicare and Medicaid programs.

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