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HHS/CMS | RIN: 0938-AT64 | Publication ID: Fall 2019 |
Title: Modernizing and Clarifying the Physician Self-Referral Regulations (CMS-1720-P) | |
Abstract:
This rule proposes to address any undue regulatory impact and burden of the physician self-referral law. |
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Agency: Department of Health and Human Services(HHS) | Priority: Other Significant |
RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Proposed Rule Stage |
Major: No | Unfunded Mandates: No |
EO 13771 Designation: Not subject to, not significant | |
CFR Citation: 42 CFR 411 | |
Legal Authority: 42 U.S.C. 1395nn |
Legal Deadline:
None |
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Statement of Need: This rule is necessary to facilitate the successful transition from volume-based to value-based payment for healthcare services and promote care coordination among healthcare providers and suppliers who furnish care to Medicare beneficiaries and other patients. This rule is also necessary to bring needed clarity and flexibility for parties subject to the physician self-referral law’s prohibitions on referrals and Medicare claims submission. |
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Summary of the Legal Basis: This rule interprets section 1877 of the Social Security Act. |
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Alternatives: We will continue to explore alternatives as we develop the rule. |
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Anticipated Costs and Benefits: We believe that this rule could have a positive impact on health outcomes of beneficiaries and other American patients because providers, suppliers, and physicians will be able to better coordinate patient care without running afoul of the physician self-referral law’s referral and Medicare claims submission prohibitions. We also believe the proposed regulatory reforms may make compliance with the physician self-referral law more straightforward. |
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Risks: Risks of the proposals in this rule are still under development and will be included in the published rule for comment. |
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Timetable:
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Regulatory Flexibility Analysis Required: Undetermined | Government Levels Affected: None |
Federalism: No | |
Included in the Regulatory Plan: Yes | |
RIN Data Printed in the FR: No | |
Agency Contact: Lisa O. Wilson Senior Technical Advisor Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Medicare, MS: C4-25-02, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-8852 Email: lisa.wilson2@cms.hhs.gov |