Stark law, noncompetes & more federal moves affecting physicians

From potential Stark law amendments to a noncompete ban, here are four recent federal moves that are affecting physicians:

1. Two district court judge rulings have challenged the Federal Trade Commissions' plan to ban noncompetes for most workers. A Pennsylvania federal court judge denied the motion for a preliminary injunction pushing the effective date of the Federal Trade Commission's noncompete ban. The judge ruled that the noncompete ban fell within the FTC's rulemaking authority, after a Texas federal court held that the ban exceeded its statutory authority, setting up a split amongst federal courts. Unless a court issues an order enjoining the enforcement of the rule nationwide, it is still scheduled to go into effect on September 4

2. A House committee unanimously advanced legislation that would make permanent an in-office ancillary services exception to Stark law for drugs provided under Medicare. The legislation would make permanent a CMS waiver instituted during the COVID-19 public health emergency that allowed Medicare patients to receive medications by mail or allow caregivers and family members to get medications for them

3. CMS proposed a 2.8% conversion factor reduction to its physician fee schedule for 2025 July 10. The decrease includes requirements that adjustments be budget neutral, the expiration of a 2.93% bump in 2024 and an adjustment related to the work relative value unit portion

4. Also in the proposal, CMS proposed that the merit-based incentive program payment system performance threshold be maintained at 75 points for 2025. The threshold for 2024 was also 75 points, despite an initial proposal by CMS to raise the threshold to 82. Some advocates, including the AMA, have criticized the points threshold and the MIPS program overall, arguing that it disproportionately penalizes small independent and rural practices.

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