Better health outcomes through coordinated patient care with effective and efficient use of Medicare resources is the goal of a bill recently introduced by U.S. Rep Larry Bucshon (R-IN).
The Medicare Care Coordination Improvement Act of 2017 would update current law so that doctors could more easily coordinate care through agreements with other health care providers.
Presently, a provision of the Social Security Act known as the Stark Law prohibits physicians from making referrals for designated health services payable by Medicare if the doctor or a family member has a financial relationship with a provider or entity providing the health care service, unless an exception under law applies, according to the Centers for Medicare & Medicaid Services (CMS). The entity is also barred from submitting Medicare claims for the referred services.
H.R. 4206 would grant CMS authority to develop certain exceptions to the Stark Law to reduce barriers to collaboration that would offer better care at lowered cost.
“As a physician, I know first-hand that patients can have medical issues requiring a coordinated team of physicians and other healthcare professionals to be on the case for effective treatment,” said Bucshon, a physician and member of the House Energy and Commerce Health Subcommittee. “The Medicare Care Coordination Improvement Act would remove legal barriers that currently prevent physicians from entering into innovative payment models that can lead to better outcomes for patients, while also saving Medicare money.”
Clinical laboratory services, physical and occupational therapy, radiation therapy, home health care, and durable medical equipment are among the 12 designated health services under which the Stark Law bans physician self-referral.
U.S. Reps. Ron Kind (D-WI), Kenny Marchant (R-TX), and Raul Ruiz (D-CA) joined Bucshon in introducing the bipartisan bill.
Two dozen medical societies and health care associations have voiced their support for the bill, including the American Academy of Neurology, the American College of Cardiology, the Medical Group Management Association, and the American Medical Association.