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Innovations in Health Care Delivery & Financing January 7, 2020

Health Law Lab Offers Government Guiding Principles for Regulatory Reform

Explicit protections under federal health care fraud and abuse laws for arrangements that support social determinants of health have the potential to profoundly impact Medicare and Medicaid beneficiaries and others, and to help health care providers succeed in achieving value-based care. This is why we were so excited last October, when we wrote about proposed revisions to certain rules, the fact that the government is specifically contemplating how to address social determinants interventions, and the opportunity for public comment to shape how the government approaches regulatory reform in this exciting—and evolving—space.

In addition to providing feedback on several specific features of the proposal, the Center for Health Law and Policy Innovation of Harvard Law School’s letter to regulators detailed three guiding principles that are critical to enabling innovation while maintaining safeguards against fraud and abuse:

                     1. Regulations must recognize the central role of community-based organizations in addressing the social determinants of health and facilitate partnerships between health care providers and such entities.

                     2. Regulations must enable local solutions to local needs.

                     3. Each condition or safeguard put in place as a guardrail must be nuanced as necessary and appropriate for supports to address the social determinants of health.

To read more about the Health Law Lab’s vision for this kind of regulatory flexibility, please review the full text of the comment letter that we submitted to the federal government.