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Anti-Kickback Statute › Alternative Payment Models (APM)

The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The... more +
The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -
Mintz - Health Care Viewpoints

CMMI Proposes Mandatory Ambulatory Specialty Model in 2026 PFS Proposed Rule: Key Considerations for Health Care Organizations...

Mintz - Health Care Viewpoints on

In the CY 2026 Medicare Physician Fee Schedule proposed rule (PFS Proposed Rule), released on July 14, 2025, the Center for Medicare and Medicaid Innovation (CMMI) introduced the Ambulatory Specialty Model (ASM), a new...more

Holland & Knight LLP

Key Value-Based Care Developments to Watch in 2024

Holland & Knight LLP on

The goal of value-based care (VBC) is to promote better care for individual patients and improved health outcomes for communities at reduced costs. This is an important and admirable purpose as many VBC stakeholders attempt...more

Foley & Lardner LLP

ACCC 47th Annual Meeting & Cancer Center Business Summit (AMCCBS): Positive Disruption in the COVID-19 ERA – Part 2

Foley & Lardner LLP on

The ACCC 47th Annual Meeting & Cancer Center Business Summit (AMCCBS) took place virtually, March 1-5. Through a combination of five-star panels and interactive drop-in sessions, attendees learned about key themes and trends...more

Bricker Graydon LLP

HHS regulatory sprint to coordinated care: Will meaningful changes make it across the finish line?

Bricker Graydon LLP on

As part of the U.S. Department of Health and Human Services (HHS) initiative known as the “Regulatory Sprint to Coordinated Care” in 2018, HHS asked industry stakeholders for information regarding how it can improve both the...more

Buchalter

Buchalter Health Care Newsletter

Buchalter on

Industry trends present a clear move from fee-for-service to value-based reimbursement models, particularly as patient engagement increases with the use of efficient technologies. As a response, new care delivery and payment...more

Mintz - Health Care Viewpoints

HHS Continues the “Sprint to Coordinated Care”

Mintz - Health Care Viewpoints on

On August 27, 2018, the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) issued a request for information (RFI) seeking comment on the anti-kickback statute (AKS) and the beneficiary...more

Baker Donelson

OIG Releases RFI Focused on Removing Barriers to Value-Based Care

Baker Donelson on

The Department of Health and Human Services, Office of Inspector General (OIG) recently released a request for information (RFI) seeking public input on "how to address any regulatory provisions that may act as barriers to...more

Bass, Berry & Sims PLC

Sprinting to Coordinated Care: Healthcare Industry Urges Stark Law Relief as OIG Solicits Feedback on Changes to the Anti-Kickback...

Bass, Berry & Sims PLC on

August 24, 2018 marked a busy day for the U.S. Department of Health & Human Services' (HHS) self-designated "Regulatory Sprint to Coordinated Care," an initiative aimed at dismantling the regulatory barriers to providers...more

Bass, Berry & Sims PLC

Stark Under the Microscope: Congress and HHS Examine Reform of the Stark Law for a Value-Based System

Bass, Berry & Sims PLC on

On July 17, 2018, the U.S. House of Representatives' Ways and Means Committee Subcommittee on Health ("Subcommittee") expressed its commitment to modernizing the Stark Law during a hearing in which industry and government...more

Chambliss, Bahner & Stophel, P.C.

CMS Request for Information – Stark Law

Chambliss, Bahner & Stophel, P.C. on

CMS is seeking input on ways to reduce the regulatory burdens of the physician self-referral law (commonly known as the Stark Law), particularly as it relates to the ongoing effort to transition from a fee-for-service to a...more

Troutman Pepper Locke

Value-Based Contracting for Prescription Drugs and Medical Devices: An Innovative Solution Impaired by Outdated Regulations

Troutman Pepper Locke on

Often lost in the cacophony of headlines surrounding rising health care costs is the promise that value-based contracting offers as a possible solution. In contrast to the traditional fee-for-service model, value-based...more

Mintz - Health Care Viewpoints

Hospitals and Others Respond to “Red Tape Relief Project” Requests

Mintz - Health Care Viewpoints on

Last week, a number of health care industry associations sent letters to Congress detailing ways in which the government could relieve them of the burdens associated with “red tape.” The letters are in response to the first...more

Carlton Fields

Provider Beware: MACRA Implementation Fraught with Fraud and Abuse Implications

Carlton Fields on

Although the fate of the Center for Medicare and Medicaid Innovation (CMMI) and the mandatory alternative payment models thereunder face threat of repeal under Republican leadership, the Medicare Access and Chip...more

McDermott Will & Schulte

Managing the Transition to Transformation: Alternative Payment Systems: Evolving Compliance Challenges

McDermott Will & Schulte on

McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery...more

McDermott Will & Schulte

Managing the Transition to Transformation: Old Dog, New Tricks: Fraud and Abuse in the Age of Payment Reform

McDermott Will & Schulte on

McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery...more

Morgan Lewis

Senate Finance Committee Examines Repeal of the Stark Law

Morgan Lewis on

A new report suggests that the Stark law is obsolete in new payment models. On June 30, the US Senate Committee on Finance (the Committee) released the report Why Stark, Why Now? Suggestions to Improve the Stark Law to...more

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