Published: 2010-01-30 19:55:43
Author: Amy Lynn Sorrel | American Medical News | January 20, 2010
Physicians have until Jan. 25 to comment on the Centers for Medicare & Medicaid Services' recent changes to federal anti-self-referral rules that have forced many physician-hospital arrangements to fold or restructure.
The federal Stark law generally prohibits physicians from referring patients to entities in which they have a financial stake. In a final rule that took effect Oct. 1, 2009, CMS instituted broad revisions that interpret an entity to include not only the party that directly bills Medicare for designated health services, but also those providing the services. Under the change, physician groups are considered to have a direct ownership stake in the designated health services they perform, barring referrals unless they can meet stricter Stark exceptions.
The changes stemmed from the government's fears that the self-referral rules were too lenient and promoted abusive arrangements that could lead to improper referrals and overutilization of services. But many physician organizations, including the American Medical Association, expressed concern about certain ambiguities in the rule change and its impact on legitimate arrangements and patient care.
In response, CMS, in its Nov. 24, 2009, publication of the 2010 Medicare Physician Fee Schedule, began soliciting comments "to determine the need for further guidance" on the issue.Full story