The Consolidated Appropriations Act of 2023 updated exceptions to Stark Law and Anti-Kickback law last year, according to a May 15 article in JDSupra from law firm Epstein Becker & Green.
Here is what to know about the updated exceptions:
Stark Law exceptions fall into three categories: exceptions applicable to any types of financial relationships, exceptions applicable to ownership arrangements and exceptions applicable to compensation arrangements. In the compensation arrangement category, Congress has issued a new exception for physician wellness programs offered by healthcare entities, including ASCs, hospitals and physician practices.
To satisfy the new exception, the program must include counseling, mental health services, a suicide prevention program and a substance abuse disorder program, and include a written policy. The written policy must include a description of the content and duration of the program, a description of the evidence-based support and the estimated costs, among other stipulations.
The Consolidated Appropriations Act also stated that HHS' office of inspector general would conduct a review whether to establish "safe harbor for evidence-based contingency management interventions and the parameters for the safe harbor," according to the article.
Contingency management, which refers to a type of behavioral therapy in which individuals are rewarded for positive behavioral change, are often used for substance abuse treatment and often involve the provision of monetary-based reinforcers.
The OIG would consider where the arrangement may result in an increase or decrease in healthcare access, healthcare quality, patient freedom of choice and competition, among other factors.