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Physician Law Current news, updates, & useful tips relating to legal issues affecting physicians & non-institutional providers in their personal & professional lives

Tag Archives: Stark

Does Your Group Practice Income Division Formula Comply with Stark

Posted in Ancillary Services, Fraud and Abuse

Many physicians I speak with are still surprised to learn that the federal Stark statute imposes restrictions on income division within group practices.  These restrictions only apply to profits generated from any of the Stark “designated health services” and only those that are covered by Medicare and Medicaid (including managed care), but if your group provides… Continue Reading

Tuomey Case Puts Sharp Emphasis on Fair Market Value in Physician Transactions

Posted in Fraud and Abuse

Earlier this month the closely watched case of U.S. ex rel Drakeford v Tuomey Healthcare System Inc. (675 F.3d 394 (4th Cir. 2012) concluded with a jury finding that the compensation paid to physicians under certain part-time employment agreements by Tuomey Healthcare System resulted in violations of both the federal False Claims Act and the… Continue Reading

President Proposes Eliminating Stark In-Office Ancillary Services Exception For Therapy and Advanced Imaging

Posted in Fraud and Abuse

In what would undoubtedly be a devastating blow to many medical practices that rely on the Stark in-office ancillary services exception (which allows physicians to refer within their practices for Stark services), President Obama’s proposed FY 2014 would seek to eliminate the exception for physical therapy, radiation therapy and advanced imaging such as CT and… Continue Reading

CMS Proposes Regulations Clarifying Stark Imaging Disclosure Requirements

Posted in Medicare

ACA requires that, with respect to referrals for magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), and any other Stark designated health services (DHS) specified by the Secretary of HHS, a referring physician must inform the patient in writing at the time of the referral that the patient may obtain the service from a person other than the referring physician.

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

Pennsylvania Qui Tam Case Highlights Dangers in Physician/Hospital Arrangements

Posted in Fraud and Abuse, Medicare, Physician Compensation

A recent whistleblower case out of the federal 3rd Circuit in Pennsylvania highlights some of the dangers in not properly documenting financial relationships between physicians and hospitals. Specifically, in US ex. rel. Kosenske v. Carlisle HMA, Inc., a Qui Tam lawsuit brought by the former member of an anesthesia group, the 3rd Circuit Court of… Continue Reading