The Consolidated Appropriations Act (CAA) of 2023 introduces significant changes to how hospitals and healthcare entities can support their physicians, especially concerning their mental health and resilience. Notably, this act includes a new exception to the Stark Law and a safe harbor under the Anti-Kickback Statute (AKS), which increase the odds that medical professionals take advantage of the opportunity to focus on their mental health.
Understanding the exception and safe harbor
The Stark Law primarily prevents physicians from referring patients to facilities if they have a financial relationship unless an exception applies. Similarly, the AKS prohibits referrals for services covered by Medicare in exchange for remuneration unless there is a safe harbor provision. The CAA of 2023 Section 4126 states that wellness programs that provide services for physicians to aid with their mental health are exempt from these laws.
Lawmakers intend this exception to help better ensure that physicians receive the support they need without the concern of violating the Stark Law or AKS.
The importance of compliance
While this provision offers much-needed flexibility, it is important to make sure that practices comply with specific requirements. The following tips can help to better ensure medical professionals do not run afoul of these laws:
- Detailed documentation of the program’s structure, purpose, and utilization
- Ensure that the programs offered are not tied to the volume or value of referrals
Adhering to these guidelines can help maintain the integrity of the programs and reduce the risk of any potential legal pitfalls.
The new provisions in the CAA of 2023 are a significant step forward in addressing the mental health needs of physicians. However, healthcare providers are wise to remain vigilant and carefully navigate the requirements set forth by the CAA of 2023 to take full advantage of the new Stark Law exception and AKS safe harbor. Proper implementation and ongoing compliance are key to leveraging these provisions effectively.
Attorney John Rivas is responsible for this communication.