Someone Is Looking to Steal from Us

Specifically, the healthcare executives who are calling for a rollback on anti-kickback laws.

They claim that this will allow for, “Innovation.”

What they really want is a way to goose their profits and their salaries, because this about self-dealing, not improving the quality or efficiency of healthcare.

Whenever I hear someone talk about how deregulation will allow for innovation, I am reminded of Paul Volker’s quote on financial innovation, that, “The only thing useful banks have invented in 20 years is the ATM.”

Let us be completely clear, this is about legalizing larceny, nothing else:

Beth Hughes’ job involves closely partnering with physicians to sync Sioux City, Iowa-based MercyOne’s operations and move the health system forward. But one regulation continues to stand in her way—the Stark law, the president of MercyOne’s Western Iowa region said.

The Stark law is meant to curb Medicare and Medicaid spending by prohibiting a physician for making referrals that financially benefit the doctor. That combined with the federal anti-kickback statue have impeded new payment models by limiting incentives used to reward progress, providers said, noting that they can incur significant financial penalties even if they didn’t intend to violate the regulations.


“Being creative with value-based care flies in the face of fraud and abuse laws,” Hughes said as organizations like MercyOne aim to reduce hospital readmissions and length of stay. “You can try to get an exception, but most people are discouraged because it is a long and arduous process. Those laws may be inhibiting our ability to creatively align ourselves with providers.”

More than 36% of 162 healthcare executives surveyed by Advis said that fraud and abuse laws don’t support new models of care—the most common answer to what regulations stand in the way of changing healthcare for the better. Fraud and abuse laws were followed by Medicare conditions of participation and state licensure laws as well as limits on telehealth reimbursement.

If this doesn’t sound like a license to cheat and steal, you have the political and financial acumen of Little Orphan Annie.

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