KSM Healthcare Blog

Our friends at the American Health Lawyer Association have alerted us to three provisions of the Patient Protection and Affordable Healthcare Act that modify the Stark regulations.

Since Stark Compliance is frequently a hot topic, here is a brief summary of the three changes:

1. Stark Self Referral Disclosure  CMS must develop and implement a self disclosure protocol for actual and potential stark violations.  CMS is also granted the authority to compromise or reduce otherwise statutory penalties.  The OIG or Department of Justice are not required to be involved in settling any cases under this protocol.
    
2. In Office Ancillary Disclosure  The in-office ancillary services exception under Stark now requires a referring physician to inform patients (in writing and at the time of the referral) that the patient may receive various ancillary services, such as imaging or other DHS services, from a source other than the referring physician / practice.  In fact, physicians must provide patients with a written list of suppliers who furnish equivalent services locally.  This is retroactively effective as of 1/1/2010.
    
3. Limits on Physician Owned Hospitals  Physicians are essentially barred from future investment in hospitals, except as meets the whole hospital exception.  Current investments are grandfathered as of a qualifying date (currently 8/1/10, but subject proposed at 12/31/10 in reconciliation bill).  There are also increased disclosure requirements and heavy restrictions on expansion of facilities, including operating rooms, procedure rooms, and beds.

Compliance with the new in office ancillary disclosure requirement is an obvious physician practice consulting item with respect to ongoing Stark compliance.  Let us know if you have any questions about the above or expected implementation.