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?
Thursday, October 1, 2009
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ReplyDeleteBest of luck,
Tim
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