Thursday, October 1, 2009

Stricter Stark rules take effect today

Stricter self-referral rules go into effect today, prompting many physicians and hospitals to rework or cancel contracts.

The Stark law revisions restrict arrangements where hospitals contract with physician-owned entities to provide ancillary services, such as imaging services. Basically, CMS has expanded the scope of designated health services to cover the entity providing the service (the doctor’s offices), consultant Susanne Madden tells me. (Susanne is writing next week’s PEARLS column on the topic, so be sure to sign up that e-newsletter.)

So, what does this all mean?
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Under the new regulations, doctors are no longer exempt from Stark rules, so it’s as if a physician is billing for his own referral services, Madden says. It’s as if they are sending patients to themselves, where before, it wasn’t considered self-referring.

Now, doctors and hospitals are left to quickly revise those contracts. Hospitals may choose to build out their own imaging services, for example. Or it looks like the hospitals may get creative to be able to contract for these services, as physicians could lease equipment or space.

How does the change effect your practice? What do you think of the expanded Stark rules?


  1. Melissa, I would love to have you chronicle your experience within EMRmatch as you move along further with your project. If you'd be willing to do this, you can learn more about EMRmatch, as well as find my contact information, here:

    Best of luck,


  2. For those of us seeking an EMR package, could you dispense with this Company A, B business and tell us who you are talking about? I need to mack a decision in a few weeks and others may be in the same boat. My client's need is for a surgical practice.

    David Bershtein,, NYC area