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Chairman Roskam Opening Statement at Hearing on Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program

July 17, 2018

WASHINGTON, D.C. –  The following prepared remarks were delivered by Rep. Adrian Smith (R-NE) on behalf of House Ways and Means Health Subcommittee Chairman Peter Roskam (R-IL) at a Subcommittee Hearing on Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program.

CLICK HERE to watch the hearing.

Remarks as prepared for delivery:

“For quite some time now there has been a discussion in this town about moving the Medicare program towards a value-based system as opposed to the volume-based system that the traditional fee-for-service system has lived under for over 50 years.

“During the last twenty years there has been some movement on this direction, on a bipartisan basis no less.

“A revamped Medicare Advantage program, a new prescription drug benefit in Medicare, and the start of Medicare shared savings programs, known more colloquially today as accountable care organizations or ACO’s now, were each one additional step towards achieving higher value and coordinated care for our seniors.

“Fast forward to three years ago, we passed the MACRA law that repealed the onerous sustainable growth rate, another legacy law of a different era that was creating undue yearly burdens on both our nation’s clinicians and in turn, patients.

“MACRA implementation is well under way, encouraging providers of all types to work together to reduce costs and to increase the quality, value, efficiency, and coordination of care steps further.

“However, there are certain laws that have long been in place to protect the program and patients, but now stand in the way of making real progress towards the goal of value over volume. 

“Today, we are here to talk about the physician self-referral law, or ‘Stark Law,’ and have an intuitive discussion as a first step towards what I know to be a needed modernization of the law.

“Stark Laws were, and in many ways still are, necessary to ensure patient safety and a safeguard over taxpayer dollars.  These laws essentially prevent physicians from making referrals to entities that provide certain services if they have any ownership of financial stake in that entity.

“Now understandably that is an oversimplification, particularly now that the web of regulations borne out of the laws are nearly impossible to navigate without legal assistance.

“In a world where we are now pushing our providers to work closely together to bring down costs, and in many cases share in the savings that they create, we need to update the laws to give providers an easing of burdens and give the Centers for Medicare and Medicaid Services more flexibility to supply waivers to these providers who get into these high value arrangements.

“For the sake of avoiding getting repetitive, I will say it just one more time: The goal here is shared by all. Better care for Medicare patients.

“We will hear from the Department of Health and Human Services today and then from providers who will share their knowledge and experience to set the table for what I hope to be an ongoing and robust discussion going into next year.”