Changes to Anti-Fraud Laws Spur ‘Paradigm Shift’ in Health Care

Recent major changes to how anti-fraud health laws are enforced pave the way for payment systems that create incentives for doctors to focus on the whole health of the patient rather than on individual treatments.

Final rules released by the Department of Health and Human Services Nov. 20 carved out new exemptions to the Physician Self-Referral law and Anti-Kickback statute, which have long been seen as barriers to paying doctors based on patient outcomes rather than for each isolated service. One rule provides new shields under the criminal kickback law, among other things, and another spells out exceptions under the ...