Stark Administrative Simplification Act of 2018
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S 3054 — Stark Administrative Simplification Act of 2018
Last action — Read twice and referred to the Committee on Finance.
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed Senate
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4Passed House
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5To Executive
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6Enacted
This bill died with 115th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
Stark Administrative Simplification Act of 2018 This bill establishes alternative protocols and sanctions for inadvertent technical noncompliance with the Stark Rule against self-referral under Medicare. "Technical noncompliance" means, with respect to a compensation arrangement, that: (1) the agreement is not signed by one or more parties to the arrangement, (2) the arrangement was a holdover arrangement for a period longer than is allowed by the Centers for Medicare & Medicaid Services, or (3) documentation of the arrangement contains specified identifying information but is otherwise insufficient to satisfy the writing requirement of an applicable exception.
Bill Text
- Introduced Introduced in Senate Current html June 12, 2018
Sections of law this bill changes
1 section in 1 lawFrom the bill's own amending language, matched to the official United States Code (current through Public Law 119-121).
Social security · 42 U.S.C. ch. 7 1 section
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§ 1395nn Limitation on certain physician referrals Amends
42 U.S.C. § 1395nn
The law today
(a) Prohibition of certain referrals (1) In general Except as provided in subsection (b), if a physician (or an immediate family member of such physician) has a financial relationship with an entity specified in paragraph (2), then— (A) the physician may not make a referral to the entity for the furnishing of designated health services for which payment otherwise may be made under this subchapter, and (B) the entity may not present or cause to be presented a claim under this subchapter or bill to any individual, third party payor, or other entity for designated health services furnished pursuant to a referral prohibited under subparagraph (A). (2) Financial relationship specified For purposes of this section, a financial relationship of a physician (or an immediate family member of such physician) with an entity specified in this paragraph is— (A) except as provided in subsections (c) and (d), an ownership or investment interest in the entity, or (B) except as provided in subsection (e), a compensation arrangement (as defined in subsection (h)(1)) between the physician (or an immediate family member of such physician) and the entity. An ownership or investment interest described in subparagraph (A) may be through equity, debt, or other means and includes an interest in an entity that holds an ownership or investment interest in any entity providing the designated health service. (b) General exceptions to both ownership and compensation arrangement prohibitions Subsection (a)(1) shall not apply in the following cases: (1) Physicians’ services In the case of physicians’ services (as defined in section 1395x(q) of this title) provided personally by (or under the personal supervision of) another physician in the same group practice (as defined in subsection (h)(4)) as the referring physician. (2) In-office ancillary services In the case of services (other than durable medical equipment (excluding infusion pumps) and parenteral and enteral nutrients, equipment, and supplies)— (A) that are furnished— (i) personally by the referring physician, personally by a physician who is a member of the same group practice as the referring physician, or personally by individuals who are directly supervised by the physician or by another physician in the group practice, and (ii) (I) in a building in which the referring physician (or another physician who is a member of the same group practice) furnishes physicians’ services unrelated to the furnishing of designated health services, or (II) in the case of a referring physician who is a member of a group practice, in another building which is used by the group practice— (aa) for the provision of some or all of the group’s clinical laboratory services, or (bb) for the centralized provision of the group’s designated health services (other than clinical laboratory services), unless the Secretary determines other terms and conditions under which the provision of such services does not present a risk of program or patient abuse, and (B) that are billed by the physician performing or supervising the services, by a group practice of which such physician is a member under a billing number assigned to the group practice, or by an entity that is wholly owned by such physician or such group practice, if the ownership or investment interest in such services meets such other requirements as the Secretary may impose by regulation as needed to protect against program or patient abuse. Such requirements shall, with respect to magnetic resonance imaging, computed tomography, positron emission tomography, and any other designated health services specified under subsection (h)(6)(D) that the Secretary determines appropriate, include a requirement that the referring physician inform the individual in writing at the time of the referral that the individual may obtain the services for which the individual is being referred from a person other than a person described in subparagraph (A)(i) and provide such individual...33 other bills also change this section · Follow it → Official text at uscode.house.gov ↗
Compared against current U.S. Code AI-generated reading aid — verify against the official bill.
The bill adds a new subsection to create alternative sanctions for technical noncompliance with the Stark rule under Medicare.
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42 U.S.C. 1395nn
(j) Self-Disclosure Protocols.--
Introduces a new subsection for self-disclosure protocols regarding technical noncompliance.
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42 U.S.C. 1395nn
(1) In general.--Beginning one year after the date of the enactment of this subsection--
Sets a timeline for the implementation of self-disclosure protocols.
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42 U.S.C. 1395nn
(A) an entity or individual may voluntarily disclose a compensation arrangement with actual or potential inadvertent technical noncompliance with subsection (a)(1) (as defined in paragraph (3)(H)) pursuant to either the self-referral disclosure protocol (defined in paragraph (2)) or the alternative protocol for technical noncompliance under paragraph (3);
Allows voluntary disclosures for inadvertent technical noncompliance.
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42 U.S.C. 1395nn
(B) disclosures voluntarily withdrawn from the alternative protocol for technical noncompliance may be submitted to the self-referral disclosure protocol; and
Permits withdrawal and resubmission of disclosures between protocols.
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42 U.S.C. 1395nn
(C) an entity that, prior to the establishment of the alternative protocol for technical noncompliance, disclosed to the self-referral disclosure protocol a compensation arrangement that was in inadvertent technical noncompliance with subsection (a)(1), may elect, not later than one year after such alternative protocol is established, to withdraw such disclosure from the self-referral disclosure protocol and instead submit the disclosure to such alternative protocol.
Enables entities to switch disclosures to the new protocol within a specified timeframe.
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42 U.S.C. 1395nn
(2) Self-referral disclosure protocol.--The term `self-referral disclosure protocol' or `SRDP' means the protocol specified in section 6409 of Public Law 111-148.
Defines the self-referral disclosure protocol in relation to existing law.
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42 U.S.C. 1395nn
(3) Alternative protocol for inadvertent technical noncompliance.--
Establishes a framework for an alternative protocol specifically for technical noncompliance.
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42 U.S.C. 1395nn
(A) In general.--The Secretary shall establish, not later than one year after the date of the enactment of this subsection, an alternative protocol for technical noncompliance (in this subsection referred to as the `APTN') to enable entities to disclose arrangements that were previously in inadvertent technical noncompliance with subsection (a)(1) and, upon the Secretary's acceptance of the disclosure, make payment of a civil monetary penalty.
Mandates the establishment of an alternative protocol for technical noncompliance and specifies civil monetary penalties.
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42 U.S.C. 1395nn
(E) Civil monetary penalties pursuant to the alternative protocol for technical noncompliance.--
Details the civil monetary penalties for disclosures under the new protocol.
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42 U.S.C. 1395nn
(F) Relation to advisory opinions.--The APTN shall be separate from the advisory opinion process set forth in regulations implementing subsection (g) of this section.
Clarifies the distinction between the new protocol and advisory opinion processes.
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42 U.S.C. 1395nn
(G) Publication on internet website of aptn information.--Not later than one year after the date of the enactment of this subsection, the Secretary shall post information on the public Internet website of the Centers for Medicare & Medicaid Services to inform relevant stakeholders of how to disclose and make payment of a civil monetary penalty for inadvertent technical noncompliance with subsection (a)(1).
Requires the Secretary to provide guidance on the alternative protocol via a public website.
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42 U.S.C. 1395nn
(H) Definitions.--In this subsection:
Introduces a definitions section specific to the new protocols.
Action History
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Introduced in Senate
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Read twice and referred to the Committee on Finance.
Sponsors
- David Perdue · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 546 not signed on
Sponsors (1)
- Perdue, David Republican
Co-sponsors (0)
None.
Not signed on (546)
546 members have not signed on to this bill.
Show all 546 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does S 3054 do?
- Stark Administrative Simplification Act of 2018 This bill establishes alternative protocols and sanctions for inadvertent technical noncompliance with the Stark Rule against self-referral under Medicare. "Technical noncompliance" means, with respect to a compensation arrangement, that: (1) the agreement is not signed by one or more parties to the arrangement, (2) the arrangement was a holdover arrangement for a period longer than is allowed by the Centers for Medicare & Medicaid Services, or (3) documentation of the arrangement contains specified identifying information but is otherwise insufficient to satisfy the writing requirement of an applicable exception.
- Who sponsors S 3054?
- S 3054 is sponsored by Perdue, David (Republican).
- What is the current status of S 3054?
- This bill died with 115th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track S 3054?
- Track S 3054 free on One Click Politics — get push/email alerts when it moves.
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