In Physician Hospitals of America v. Sebelius, the U.S. District Court for the Eastern District of Texas upheld § 6001 of the Patient Protection and Affordable Care Act of 2010 (PPACA), which prohibits new physician owned hospitals and the expansion of those already existing.
CMS Announces New Stark Self-Referral Disclosure Protocol
By Michael Cassidy on
Posted in Fraud - Stark
New – Medicare Self-Referral Disclosure Protocol
CMS has published the self referral disclosre protocol required by ACA. Link and announcement below. Analysis will be posted next week.
Section 6409(a) of the Affordable Care Act (ACA) ACA requires the Secretary of the Department of Health and Human Services, in cooperation with the Inspector General of…
CMS Position on Whole Hospital Physician Ownership Stark Exception
By Michael Cassidy on
Posted in Fraud - Stark
Physician Self-Referral
CMS proposes to implement changes enacted in ACA to the "whole hospital" and "rural provider" exceptions in the physician self-referral law that will prohibit their use by new physician-owned hospitals and limit the ability of existing physician-owned hospitals to expand their capacity. The deadline for physician investment and having a provider agreement…
October 1, 2009: Effective Date of New Stark Rules
By Michael Cassidy on
Posted in Fraud - Stark, Medicare & Reimbursement
This is just a reminder of the effective date for certain new Stark Rules:
1. CMS prohibits percentage formulae conjunction with space on equipment leases, fair market value exception transactions and indirect compensation effective October 1, 2009.
2. Per click leases are prohibited effective October 1, 2009.
3. "Under arrangement" relationships have been changed because…
OIG Advisory Opinion 09-05 Approves Physician On Call Compensation
By Michael Cassidy on
Posted in Fraud - Stark
The Office of Inspector General of the Department of Health and Human Services has issued Advisory Opinion No. 09-05, which states that the OIG will not impose sanctions regarding a proposed on call arrangement in which the hospital will compensate physicians for providing on call coverage for patients presenting to the hospital or emergency department. The…