On Friday, November 20, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released final regulations to remove certain barriers to the implementation of physician compensation arrangements under value-based payment arrangements posed by the “Stark” Physician Self-Referral law. The new regulations are the first substantive changes to the regulations in two years and the first attempt by CMS to update the regulations specifically to address value-based payment arrangements that have proliferated since the regulations were initially implemented in the early 2000s.

The new rules contain three new exceptions to the Stark law’s general prohibition on physician referrals for designated health services to entities with which the physician has a financial relationship that are specifically targeted at value-based arrangements; one for value-based arrangements involving full financial risk, one for value-based arrangements with meaningful downside risk for physicians, and one for value-based arrangements that involve neither full financial for physicians or meaningful downside risk.

On October 29, 2020, Governor Wolf signed House Bill 81 into law, creating new minimum education and certification requirements for central service technicians and surgical technicians working in the Commonwealth, and regulating the practice of surgical technology. The Act will take effect on December 28, 2020.

Central Service Technicians

The Act defines central service technicians (“Central Tech”) as “an individual who provides the services of inspecting, assembling, decontamination, preparation, packaging and sterilization of reusable medical instruments or devices.” Under the Act, a health care facility cannot employ or otherwise contract for the services of a Central Tech unless the individual has successfully passed a nationally accredited central service exam for central service technicians and holds and maintains either a certified registered central service technician or a certified sterile processing and distribution technician credential. Currently employed health care facility Central Techs and contracted Central Techs are grandfathered from the requirements, but any Central Tech that is considered a new employee must meet the minimum requirements within 18 months from the date of hire. Techs must complete 10 hours of annual continuing education. The Act directs the Department of Health (“DOH”) to promulgate regulations necessary to implement the Act’s requirements, and grants the DOH general oversight.