Enforcers of anti-kickback laws are turning up the heat on hospitals, health systems and physicians alike, with 2024 on track to see ever increasing penalties and stress on providers. Commonly known as the Stark Law, the Physician Self-Referral Law (42 U.S.C. §1395nn) of 1989 prohibits physicians from referring patients to receive “designated health services” payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship, unless an exception applies.

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The Centers for Medicare & Medicaid Services released a proposed rule this week that would boost hospitals’ inpatient payment rates by 2.6%. Hospitals groups have swiftly voiced their opposition to this plan, arguing that this payment update will jeopardize hospitals’ financial stability.

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Intravascular Microaxial Left Ventricular Assist Device Manufacturer Payments to Cardiologists and Use of Devices

Mechanical circulatory support devices are increasingly used by physicians for patients receiving percutaneous coronary intervention (PCI). Use of intra-aortic balloon pumps (IABPs) has decreased, whereas use of intravascular microaxial left ventricular assist devices (LVADs) grew from 4.1% to 9.8% of all PCIs for acute myocardial infarction complicated by cardiogenic shock from 2015 to 2017, despite […]

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Adapting FMV Physician Compensation to CMS MPFS Changes

On November 2, 2023 the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule (“MPFS”) Final Rule which included a 3.37 percent decrease in the MPFS conversion factor from $33.8872 to $32.7442. The Final Rule also indicated the expiration of the 1.0 GPCI floor on December 31, 2023. However, on […]

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Provider Strategy reports on market developments and insights related to the healthcare provider workforce. Our publication is committed to improving the healthcare professional workforce, utilization of providers, and ultimately supporting thought leadership in workforce innovation.

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