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In November, the U.S. Department of Health and Human Services issued two final rules, modifying existing policies to assist physicians in transitioning to value-based care. Here are the five main takeaways that a healthcare administrator and providers must know:
1. The final CMS rule eases unnecessary regulations on healthcare providers and reinforces the physician self-referral law’s goal of protecting patients from unnecessary services and more expensive care.
2. Opens additional avenues for healthcare providers to coordinate patient care – allowing providers across different healthcare settings to work together and ensure quality patient care. The new exceptions permit physicians and other healthcare providers to enter into value-based arrangements where activities are legitimate, coordinate and improve the quality of patient care and lower costs. These exceptions apply regardless of CMS participation.
3. Clarifies and provides guidance on technical compliance requirements, effectively reducing administrative burdens and costs. This acts in furtherance of the Trump Administration’s “Patients over Paperwork” initiative.
4. The final rule provides new exceptions which permit non-abusive beneficial arrangements between healthcare providers; such as the donation of cybersecurity technology which safeguards the integrity of healthcare, regardless of whether the parties have other mutual business arrangements.
5. The new rules take effect on January 19, 2021.
