AHA urges Congress to remove legal barriers to value-based payment arrangements

Congress should adopt a single broad exception to federal fraud and abuse laws for financial relationships designed to foster collaboration, efficiencies and improvements in health care, AHA told leaders of the Senate Finance and House Ways and Means committees today. “Hospitals, physicians and other health care providers must break out of the silos of the past and work as teams to achieve the efficiencies and care improvement goals of the new payment models,” wrote AHA Executive Vice President Tom Nickels, in response to the committee’s request for input on how to improve the physician self-referral (Stark) law to implement new value-based payment models. “To do that, a legal safe zone for those efforts is needed. In our view, the Stark law is not suited to the new models and should not be the locus of oversight for these new arrangements. The statute and its complex regulatory framework are designed to keep hospitals and physicians apart – the antithesis of the new models. Its core provisions micro-manage compensation arrangements on a strict liability basis that has proved unworkable…. We recommend that [an] exception be created under the anti-kickback statute and arrangements protected under the exception be deemed compliant with the Stark law and relevant [civil monetary penalties].”