President Donald Trump's administration asked physicians and hospitals for help rewriting kickback regulations in what officials call a "regulatory sprint to coordinated care," The New York Times reports.
Here's what you should know:
1. Current federal laws ban providers participating in the Medicare or Medicaid programs from making payments in exchange for referrals. They also include limitations on a physician's ability to refer patients to businesses where he or she has a financial interest.
2. The statues are intended to prevent kickbacks and other payments from influencing treatment decisions, but critics say they're a barrier to care coordination efforts.
3. Now, the Trump administration has requested proposals for "a new exception to the physician self-referral law" and "exceptions to the definition of renumeration." In response, healthcare providers and lobbyists have sent hundreds of letters asking the government to scale back federal fraud and abuse laws.
4. In their recommendations, physicians, hospitals and drug companies ask the government to offer legal protection for value-based care arrangements. They argue current regulations prevent payers from rewarding Medicare patients who adhere to treatment protocols and deter hospitals from offering physicians bonuses for cost savings or good outcomes. Federal officials say the request is a "regulatory sprint to coordinated care."
5. However, rewriting regulations has the potential to increase the risk of fraud. James Pepper, a lawyer who has represented healthcare whistleblowers, said the administration's request is an invitation for healthcare companies to create loopholes they can use if investigated or prosecuted.
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