The Office of the Inspector General (OIG) recently announced key changes to the Anti-Kickback Statute (AKS). The feds state these changes will aid in transforming the healthcare marketplace into one that focuses on value-based care as opposed to the current fee-for service system.
Why does this matter?
Healthcare providers throughout the country are trying to do what is right for their patients. In some circumstances, federal regulations like the AKS can hinder the ability to work together with other providers. A failure to abide by the AKS is a very serious matter. Those who are accused of a violation face severe criminal penalties.
These changes should remove, or at least lower, this hurdle. As such, medical professionals can move forward with professional relationships that will result in care that is both of a higher quality and more efficient for their patients.
What should medical professionals know about this new rule?
The final rule, issued by the OIG November 20, 2020, led to a number of changes. Three important things to know include:
- In-kind remuneration. The changes provide protection for the exchange of in-kind remuneration, whether technology or services. If monetary remuneration is present, the agreement must generally include a substantial assumption of risk.
- Exceptions. The OIG also notes that certain entities are not eligible for value-based safe harbors. These include pharmaceutical manufacturers, distributors and wholesalers as well as laboratory companies and those that sell durable medical equipment.
- Cybersecurity. The agency updates to this rule also results in remuneration for cybersecurity technology and services. The OIG states the move is an effort to help better ensure improved cybersecurity within healthcare.
These are just a few of the changes that result from the new, finalized rule. It is wise to review the implication of these changes before moving forward with a proposed healthcare transaction or referral arrangement.