Medicare Providers Take Note: Stark Law-Related Changes from CMS - McDermott Will & Emery

Medicare Providers Take Note: Stark Law-Related Changes from CMS


In the last few months, the US Centers for Medicare & Medicaid Services (CMS) has made several noteworthy changes and provided a material clarification for providers and suppliers who are subject to the federal physician self-referral law (commonly referred to as the Stark Law). First, recognizing that certain aspects of the submission protocol have been identified as burdensome by stakeholders, CMS streamlined its voluntary self-disclosure process for certain disclosing parties, significantly reducing the number of forms needed to comply with the Stark Law Voluntary Self-Referral Disclosure Protocol (SRDP). Additionally, CMS updated and created new forms under the SRDP, the use of which, effective as of March 1, 2023, is now required. Separately, CMS also recently revised its process for updating its Stark Law code list, which formally defines certain service codes within four categories as designated health services (DHS) under the Stark Law. While updates to the DHS code list are generally released without much fanfare, CMS’s regular annual updates to the Stark Law code list have also changed the scope of services and providers who are subject to the Stark Law. Finally, CMS provided an important clarification that may affect the ability of providers and suppliers to reconcile payment discrepancies more than 90 days after a compensation arrangement has ended.