The end of the COVID-19 Public Health Emergency (PHE) is now behind us, and the discontinuation of certain PHE policies spans far beyond COVID-19 tests and vaccinations. In fact, the PHE’s end also has compliance considerations that every practice must know.
Among these are vast changes to the Stark law and the ending of blanket waivers that prevent violation accusations. Find out what your practice needs to know if you want to avoid violations.
First, Understand What the Stark Law Says
The Stark Law is a major federal statute that prohibits physicians from referring patients for designated health services (like tests, diagnostic imaging, physical therapy and more) if they have a financial relationship with the recipient of that referral.
Example: Suppose the physician owns a part of a toxicology lab processing samples for Medicare patients. The physician cannot refer their patients to that laboratory, because the physician has a financial relationship there. In other words, the more the physician refers, the more money they get because the lab has higher profits. For this reason, the Stark law prohibits these types of relationships.
How the PHE Impacted Stark
When the Public Health Emergency began three years ago, CMS waived certain types of conduct which would otherwise have been a problem under the Stark rules. Practices didn’t have to apply for such waivers—instead, they were known as blanket waivers, meaning they applied broadly across the Medicare spectrum.
Under the blanket waivers, providers needed to be providing care in response to the pandemic that did not create fraud and abuse concerns. In addition, any providers who wanted protection under these blanket waivers needed to maintain documentation.
However, with the end of the PHE, these blanket waivers went away and will no longer be accepted by the Medicare program.
Perform a Compliance Audit
With the Stark blanket waivers gone now, it’s essential that practices perform compliance reviews to ensure that any relaxed standards you adopted during the PHE have been buttoned up. You should reach out to a compliance attorney to ensure that you aren’t violating the Stark law, but in general, performing the following steps may help you identifying potential violations:
- Determine whether you put any arrangements into place during the PHE that fell under the blanket waiver.
- Evaluate whether any of those arrangements are continuing beyond May 11, 2023.
- If some of those relationships are expected to remain in place post-PHE, make sure the policies are allowed under Stark, and if not, either discontinue those relationships or work with an attorney to request waivers from the government.
Your responsibility is to protect your practice from any accusations of wrongdoing and ensure that all of your relationships are compliant. By working together with your practice’s counsel, you can ensure that you stay on the right side of the law as the PHE waivers are lifted.
Don’t miss out on how the laws have changed with the end of the PHE. Let healthcare attorney Adam Laughton, JD, walk you through the changes you must know to stay compliant and keep collecting. Sign up today for his 90-minute online training event, Prevent Telehealth Errors and Financial Losses as the PHE Ends.
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