August 24, 2018
The Honorable Seema Verma
Centers for Medicare & Medicaid Services
Hubert H. Humphrey Building
202 Independence Avenue, S.W., Room 445-G
Washington, D.C. 20201
Re: CMS-1720-NC, Request for Information Regarding the Physician Self-Referral Law
Dear Administrator Verma,
The Medical Group Management Association (MGMA) is pleased to submit the following responses to the Centers for Medicare & Medicaid Services’ (CMS’) Request for Information (RFI) on how the Physician Self-Referral (Stark) Law might be improved. We commend CMS for recognizing the need to remove unnecessary regulatory barriers to clinical and financial integration and for seeking stakeholder feedback on how this can be done.
MGMA is the premier association for professionals who lead medical practices. Since 1926, through data, people, insights, and advocacy, MGMA empowers medical group practices to innovate and create meaningful change in healthcare. With a membership of more than 40,000 medical practice administrators, executives, and leaders, MGMA represents more than 12,500 organizations of all sizes, types, structures and specialties that deliver almost half of the healthcare in the United States. Our members work on a daily basis to ensure that the financial and administrative mechanisms within group practices operate efficiently so physician time and resources can be focused on patient care.
Few, if any, federal regulations affect the structure and operation of physician group practices to the extent of the Stark Law. MGMA has worked with Congress and CMS for almost 30 years in repeated efforts to reduce regulatory burden. Unfortunately, those efforts have been highly frustrating; with each successive CMS rulemaking under the Stark Law, the regulatory scheme has become more complex, to the point where it is now virtually unfathomable to all but the most specialized attorneys and compliance consultants. Many smaller group practices simply cannot afford these resources, and in any group practice, each dollar devoted to them is a dollar diverted away from efforts to promote better patient care.
While MGMA appreciates CMS’ efforts to remove unnecessary government obstacles to value-based payment reform, we recognize CMS has not been given the legislative authority to resolve fundamental problems with the Stark Law. Meaningful improvement of this rule requires congressional action, as any progress made to reform regulations implementing the statute will be undercut by the law’s strict liability regime and disproportionate penalty provisions.
August 24, 2018