U.S. shift to value-based health care requires updated fraud, abuse laws
The HLC, a partnership of chief executives from the top health care companies in the U.S., believes these changes would allow for a smoother transition from the current fee-for-service care to the innovative value-based system. The group has been pushing for several regulatory and legislative changes specifically for the Federal Anti-Kickback Statue, the Physician Self-Referral (Stark) Law and the Civil Monetary Penalties Law.
The HLC statement highlights that legal frameworks need to enable cross-sector partnerships for patient-serving care delivery as well as payment models. This will serve to improve and strengthen the quality of health care, as well as to decrease the growth rates of health care costs.
“To improve quality of care and reduce costs, new care delivery and payment models are designed to encourage greater integration and coordination of care and payment between and among providers and industry stakeholders,” according to the HLC statement. “However, these models may still align financial interests in ways that trigger the current fraud and abuse legal framework. Changes to the current framework may be necessary to make it more compatible with health care delivery system transformation while retaining appropriate protections against fraud and abuse.”
The statement is part of the Finance Committee’s “Examining the Stark Law: Current Issues and Opportunities” meeting from yesterday, July 12.
Organizations in this story
Healthcare Leadership Council 750 9th St NW Washington, DC - 20001