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Protecting Payment for Value – OIG and CMS Propose New AKS Safe Harbors and Stark Exceptions

On October 9, 2019, the U.S. Department of Health and Human Services Office of the Inspector General (“OIG”) and Centers for Medicaid & Medicare Services (“CMS”) released their long-awaited proposed rules describing potential changes to regulations implementing the federal anti-kickback statute (the “AKS”), beneficiary inducement provisions of the civil monetary penalty law (the “CMPL”), and the physician self-referral law (the “Stark Law”). OIG and CMS have described the changes as efforts to reduce barriers to the coordination and delivery of value-based care.

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House and Senate Health Reform Bills: A Side-by-Side Comparison


Time to Read: 1 minutes Practices: Health Care

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Senate Majority Leader Harry Reid (D-Nev.) unveiled the Senate’s much-anticipated healthcare reform bill, the “Patient Protection and Affordable Care Act,” on November 18. Under the legislation, 94 percent of legal residents would be covered, or an additional 31 million of the 45 million currently uninsured. The bill includes a public plan option but permits individual states to opt-out. According to the Congressional Budget Office (CBO), the total cost of the bill is $848 billion over 10 years, comfortably under the $900 billion limit set by President Barack Obama. After offsets, the bill is projected to reduce federal budget deficits by $130 billion over the 10-year period, 2010-2019.

Several procedural hurdles remain before debate on the bill can proceed on the Senate floor, and it remains unclear whether the Democratic leadership will have the 60 Senate votes necessary to proceed. A key vote is scheduled for Saturday evening. If the requisite votes are obtained, debate may begin as early as this Sunday, prior to the Thanksgiving recess. With significant areas of controversy remaining, debate on the Senate bill will likely last several weeks, and numerous amendments are expected.

Sharp differences remain between the Senate proposal and the House-passed bill released in late October. Ropes & Gray has prepared a side-by-side comparison of these bills, available by clicking here or by visiting our Health Reform Resource Center, where you can also find copies of both bills and the CBO estimate, as well as other documents and materials relevant to this historic debate. For more information on the Senate bill or on health reform generally, contact your regular Ropes & Gray attorney or any of the attorneys listed above.
 

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