On Monday March 30, the Centers for Medicare and Medicaid Services (CMS) published blanket waivers to some of the Stark law requirements. The waivers are detailed and provide many examples of how they will apply. You can view the waivers here, but we think the important takeaways are as follows:
- CMS is only waiving requirements with respect to financial relationships and referrals in response to the COVID-19 pandemic
- The waivers only apply to direct financial arrangements between providers and physicians. The waivers do not apply to the indirect compensation arrangements exception, which many of you, particularly AMCs, rely on for financial support arrangements between teaching hospitals and faculty practice plans
- The waivers remove concerns about the following:
- Whether you have the documentation in place (written agreement, signatures) before the arrangement starts
- Whether amounts you are paying a physician for personal services are FMV
- Whether amounts you are being paid by a physician for space, equipment, or items (e.g., PPE; telehealth equipment) are below FMV
- Whether support you are providing in the form of incidental medical staff benefits (e.g., meals, clothing, child care, etc.) exceeds the value limits
- Whether support you are providing in the form of nonmonetary compensation (again, such as meals, clothing, hotel rooms, child care, transportation, isolation-related needs) exceed the value limits
There are many other waivers that have a more narrow scope but are worth consulting as you address a particular arrangement.
To see additional updated regarding COVID-19, visit our COVID-19 resources page.