'SGR Fix' Law Adds Program-Integrity Tools, Exempts Gainsharing From Penalties

Troy Barsky, a Washington, D.C.-based partner in the firm's Health Care Group, explains recent legislation designed to repeal the sustainable growth rate (SGR) formula for physician reimbursement, as well as provisions echoing the fraud and abuse mandates in the Affordable Care Act. "This is a strong message from Congress that the focus on fraud and abuse is here today," Barsky said. "The bill was supposed to focus on physician payments, but…having a strong compliance program is vitally important if you continue to operate in this space."