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10 Jun 2021 • 

The Problem of the Square Peg and the Round Hole: When Fee for Service and Managed Care Collide

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Jun 2021

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Newly Listed
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The Stark Law makes little sense in a managed care world and some sense in a purely FFS world. In the new rule, CMS takes its most substantial stab .. Read more to date at addressing this messy middle by creating three new exceptions for “value-based” arrangements. The Stark Law’s prohibitions make little sense in a purely managed care world and some sense in a purely fee-for-service world. But what about when these worlds collide (or at least coincide)? In the 2020 rulemaking, CMS took its most substantial stab to date at addressing this messy middle by creating three new exceptions for “value-based” arrangements. We will (i) unpack the key terms underlying all three exceptions; (ii) highlight commonalities and distinctions among the exceptions; and (iii) identify open questions and issues that may present challenges for parties seeking to rely on one or more of these exceptions. If you are not already a client of Dentons, please do not send us any confidential information.

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