November 23, 2020
On November 20, the Centers for Medicare and Medicaid Services (CMS) and HHS Office of the Inspector General (OIG) finalized new regulations to modernize the physician self-referral law and anti-kickback statute, including an ASTRO-backed plan to expand the distance that health care providers can provide local transportation support to rural patients. The rules respond to concerns from the health care community about the need for the physician self-referral and anti-kickback laws to accommodate the transition from fee-for-service to value-based care. CMS created new self-referral exceptions for value-based payment arrangements, while OIG created or modified safe harbors under the anti-kickback statute.
In a December 24 , 2019, letter drawing on the efforts of ASTRO’s Rural Task Force, ASTRO supported OIG’s plan allow providers to offer local transportation services to patients up to 75 miles, beyond the existing 50-mile limit. While ASTRO urged OIG not to place a mileage limit on local transportation given the long distances some radiation oncology patients travel for treatment, OIG decided to set the limit at 75 miles, although there will be no limit involving patients discharged from inpatient facilities.
According to CMS, the final rule: