Listen now (28 mins) | Listen Now Over the past several years the Congress and Medicare regulators have discussed reforming the 1989 Ethics in Patient Referral Act. Otherwise known as the physician self-referral or more commonly termed Stark law (named after the former California House member, Pete Stark, the initial sponsor of the bill). Stark law is today widely viewed as an impediment to care coordination or payment models that financially incent providers to improve care, care coordination and reduce spending growth, or moreover Accountable Care Organizations (ACOs) and bundled payment arrangements, because as implied the law prohibits physicians from referring patients to receive "designated health services" payable by Medicare or Medicaid from entities with which the physician or immediate family member has a financial relationship. Beyond the complexity of the law, its strict liability provision, potential substantial fines imposed under the law, exposure to False Claims liability and Medicare exclusion, there has been increasing sentiment the law generally does not have a place in today's pay for performance or pay for value world. Most recently, this past June 25th DHHS published a Request for Information (RFI) soliciting stakeholders to offer comments on improving Stark law and most recently, or on July 17th, the House Ways and Means heard related testimony.