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12/02/2020

CMS Announces Historic Changes to Physician Self-Referral Regulations

On November 20, CMS finalized changes to outdated federal regulations that have burdened health care
providers with added administrative costs and impeded the health care system’s move toward value-based
reimbursement. The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a
physician from making referrals to an entity for certain health care services if the physician has a financial
relationship with the entity. The old federal regulations that interpret and implement this law were designed for
a health care system that reimburses providers on a Fee-for-Service basis, where the financial incentives are
to deliver more services. However, the 21st century American health care system is increasingly moving
toward financial arrangements that reward providers who are successful at keeping patients healthy and out of
the hospital, where payment is tied to value rather than volume.

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