The 2011 Medicare Physician Fee Schedule adds an additional requirement to the in-office ancillary services exception of the Stark Rules. New Section 411.355(b)(7) requires that providers of MRI, CT and PET services must provide a written notice to the patient at the time of the referral, advising that the patient may receive the same services from a person other than the physician or that physician’s practice.
· The notice must provide at least five other suppliers within a 25 mile radius of the physician’s office, so long as there are at least five such providers. If there are not five providers, the physician must list all of the suppliers within the 25 mile radius.
· The notice should be written in a manner sufficient to be reasonably understood by all patients and should include for each supplier on the list, at a minimum, the supplier’s name, address and telephone number.
· Provision of a written list of alternate suppliers will not be required if no other suppliers provide the services for which the individual is being referred within the 25 mile radius.
Many states already have self-referral disclosure obligations for Medicaid or Workers Compensation services. We suggest that you not treat this as the type of disclosure you hear in certain advertisements, in which the disclosure of possible side effects is so burdensome and so obvious, and the attempt to minimize the disclosure so apparent, that the disclosure itself assumes added prominence or implies that it is being provided because required by law.
Patients have come to see you because they trust you. If you prescribe an imaging service and tell them that they can obtain that imaging service right in your office, or they are free to obtain it from any other supplier they choose and you’d be happy to give them a complete list, you will satisfy your disclosure obligations and communicate well with your patient. The Act does not require that you advise the patient that the disclosure is mandated by the Stark Rules. You should not grumble about government interference with your practice. Give them the list and offer to help them in any way you can.
Click below to view the additional requirement: