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Tag Archives: reform

New Requirements on Stark In-Office Ancillary Services

Posted in Ancillary Services, Fraud and Abuse, Health Reform, Medicare

Among its many provisions, the newly signed Patient Protection and Affordable Care Act has imposed a new requirement on physicians who rely on the Stark "In-Office Ancillary Services" exception.  Physicians who refer patients for CT, MRI or PET (or other Stark services as designated by the Secretary of HHS) that will be provided by the referring physician’s practice… Continue Reading

Medicare Physician Fee Reform May be on the Way

Posted in Medicare, Reimbursement

On November 24, 2009, the U.S. House of Representatives passed the Medicare Physician Payment Reform Act" (H.R. 3961) which would repeal the scheduled 21% fee reduction scheduled for January 2010.  The legislation would also permanently replace the existing Sustainable Growth Rate (SGR) formula with a new formula that, according to the House summary: Removes items such as drugs and… Continue Reading

Physician Owned Hospitals Targeted in Baucus Reform Proposal

Posted in Health Reform

The original Stark II regulations included an 18 month moratorium on an exception to Stark that would have permitted physician to invest in specialty hospitals. Since expiration of that moratorium some physicians seeking more control over their practice environments have embarked on a mission to develop specialty hospitals as an alternative to the traditional acute care hospital… Continue Reading