HHS Forging Ahead on Improving Coordinated Care

Health and Human Services (HHS) Deputy Secretary Eric Hargan held the first of many listening sessions to gain stakeholder perspectives regarding regulations that are barriers to coordinated care.  As the health industry has been trying to move away from a fee-for-service system and towards value-based care, some barriers in coordinated care can be addressed with updated regulations, and others might simply be resolved with additional guidance and clarity.  The meeting was executive-level and among the participants alongside the Healthcare Leadership Council (HLC) were the American Hospital Association, American Medical Association, the Federation of American Hospitals, and AdvaMed.  Representatives from the various HHS agencies such as the Office of the National Coordinator, Office of Civil Rights, Centers for Medicare and Medicaid and others were also present to lend their understanding of current regulations as needed.

Much of the discussion focused on the Stark Law and Anti-Kickback Statute (AKS), fraud and abuse laws that were passed in the 1970’s and have since been recognized as outdated in the current integrated healthcare economy.  Representatives around the table agreed that these laws hold providers back from becoming a greater part of surrounding communities and making an impact outside of the hospital setting on population health.  Follow up practices that concentrate on adherence once patients have been released could be greatly improved by updating these regulations.  Harsh penalties associated with Stark and AKS are said to stymie innovation and experimentation across the delivery system.

Another topic that received attention was proposed amendments to 42 CFR Part 2, which provides stricter protections on medical information surrounding drug and alcohol abuse. The heightened confidentiality was originally viewed as protecting patients from stigma and certain social repercussions. However, with the opioid crisis that has overtaken this country, it is now viewed as a hindrance to providers in that they are not fully informed with their patients’ past struggles.  A doctor who does not have full access to a patient’s medical record will not be able to treat the whole patient effectively.  It was agreed that more clarification on the differences between the Health Insurance Portability and Accountability Act (HIPAA) and 42 CFR Part 2 is needed.

HLC is pleased with Deputy Secretary Hargan’s intent to take action to improve coordinated care and is encouraged by the inter-agency communication on the current regulatory barriers.  HLC has already been focused on necessary updates to Stark and AKS laws, and a white paper is available here.  For more information on 42 CFR Part 2 please visit http://www.helpendopioidcrisis.org/.