Stark Law

Sarah, I've not encountered this before. I think the only way to alleviate such concerns would be to approach Medicaid to see if you can get them to issue an opinion letter stating that these arrangements are not considered violation of Stark. Alternately, they could potentially issue a waiver, especially since Centering is a key initiative that they support and pay for and is saving them $millions. Here is some fairly clear background on Stark:

www.beckershospitalreview.com/legal-regulatory-issues/15-things-to-know-about-stark-law-021717.html

4. The intention behind the original statute was to eliminate any financial motivation for physicians to send patients for unnecessary testing that could raise overall healthcare costs.

10. The complexity of Stark Law has left hospital executives, Congress and CMS struggling with the boundaries of the legislation — especially as the healthcare industry replaces traditional fee-for-service medicine with value-based care.

11. Stark Law requires physicians receive only fair-market prices for their services, and the serious costs associated with technical violations of the law have made hospitals hesitant to move forward with pay-for-performance initiatives.

13. In early February (2017), HHS released a report that provides observations on the effects of Stark Law and the Anti-Kickback Statute on the industry's transition to value-based payment models. In the report, HHS said some gainsharing and similar arrangements can be structured in a way that does not violate the Anti-Kickback Statute and meets the requirements of Stark Law. However, HHS noted the current fraud and abuse laws "may serve as an impediment to robust, innovative programs that align providers by using financial incentives to achieve quality standards, generate cost savings and reduce waste."

14. Legislators and hospital leaders have expressed concerns about Stark Law in recent years. For instance, during a Senate Finance Committee hearing last July, Chairman Orrin Hatch (R-Utah) said Stark Law has become too complex, creating obstacles in the transition from the antiquated fee-for-service model.

15. Sen. Hatch's views were echoed by several healthcare leaders during the hearing, including Ronald Paulus, MD, CEO of Asheville, N.C.-based Mission Health. Dr. Paulus said problems with the physician self-referral law can't be fixed by tinkering around the edges. He believes a full repeal is necessary to allow health systems to move forward with population heath efforts.

Like I said in the original post, considering the vociferousness and certainty of their objection (in one case), i doubt i'm going to change their minds about this. I may ask Medicaid for the letter of support as you suggested and see if that helps. 

Thanks for the followup Sarah. I think we all learned something from this thread.

As I circle back around to working in SC, I have re read this thread and some online articles and am once again bemused by the complexities
that surround efforts to simply provide better care!
Cross one hurdle and another rears its ugly head - after writing this I looked at the history of the Stark Law and it has been around since 1989.
Was expanded in 1995 and revised again  in 2016.  
So it has been here as long as Centering has. So why are we just hearing about it now, despite many many Centering sites having relationships with hospitals.?
I also see on the discussion chain, that the lawyers agree the site in question does violate the law. Are other sites impacted  by this law.?
How do we help them work with it?
More challenges to providing better care!
Margie