Linda Baumann Comments on Uncertainty in Health Care Policy Under the Trump Administration

The article, “Outlook 2017: New Year May Bring Stark Reform, ACA Repeal, Heavy Dose of Uncertainty,” discusses what the health care industry can expect in 2017 under the incoming Trump Administration, including the repeal of the Affordable Care Act (ACA) and potential changes to the Stark law. Linda remarks that fraud and abuse enforcement initially is likely to be on autopilot as the Trump Administration focuses on ACA repeal, but a large number of ongoing investigations, prosecutions and settlements are likely to continue since Trump’s choice for Attorney General (Senator Jeff Sessions) is a former prosecutor (and because fraud and abuse enforcement is such a lucrative revenue source for the government). However, Linda also notes that it remains to be seen whether the Trump Administration eventually will ease health care regulatory burdens or change the level of enforcement. With regard to the possibility for changes in the Stark law that prohibits certain physician self-referrals (and that has led, when used in conjunction with the False Claims Act, to multimillion dollar cases against numerous health providers), Linda notes that while “much of the congressional interest in Stark law overhaul over the past two years arose because of the law’s inconsistency with new Medicare reimbursement methodologies promoted by the Obama Administration, if these new methodologies are discontinued by a Trump Administration, the basis for Stark law repeal or revision will shift.”

Click here to read the full article in the Health Care Fraud Report.