CMS Issues Stark Act Voluntary Self-Referral Disclosure Protocol – 9 Key Concepts

Posted by Jason Greis on October 17, 2010 under Articles | Be the First to Comment

The Patient Protection and Affordable Care Act (PPACA) requires the Secretary of the Department of Health and Human Services (HHS), with the Office of the Inspector General (OIG) of HHS, to establish a protocol for healthcare providers and suppliers to disclose actual or potential violations of Section 1877 of the Social Security Act (Stark Act). Under the Stark Act, healthcare providers and suppliers may not refer patients to any entity for certain services if the physician has a financial relationship with that entity, unless an exception for such referral applies. Read More...

Exploring the Adverse Impact of Federal Healthcare Reform on Physician-Owned Hospitals

Posted by Jason Greis on April 1, 2010 under Articles | Read the First Comment

After almost a year of heated debate, President Obama signed into law the Patient Protection and Affordable Health Care Act (P.L. 111-148) (“PPACA” or the “Act”) on March 23, 2010, as amended by the Health Care and Education Affordability Act of 2010 (H.R. 4872) (“HCEAA”) on March 30, 2010.  While many of these laws’ provisions are benign, some contain “bombshells” that will permanently alter the business and regulatory landscape for certain businesses.  One such provision is contained in Section 6001 of PPACA, which significantly curbs physician ownership and investment in hospitals by restricting application of the Federal Ethics in Patient Referrals Act’s (the “Stark Law”) statutory “whole-hospital exception.” Read More...

OIG Bars Stark-Only Violations From Self-Disclosure Protocol

Posted by Jason Greis on May 22, 2009 under Articles | Be the First to Comment

Providers, including LTACHs and physicians, can no longer resolve potential Stark law-only violations through the HHS Office of Inspector General’s Provider Self-Disclosure Protocol, unless such violations are paired with Federal Anti-Kickback violations, according to the Office of the Inspector General’s recent open letter to providers.  The letter, signed by Inspector General Dan Levinson, also notes that providers will no longer be able to get past the OIG’s front door in this context unless they anticipate a minimum kickback settlement amount of $50,000.  Read More...

11 Key Concepts from the Stark Law

Posted by Jason Greis on March 6, 2009 under Whitepapers | Be the First to Comment

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Physician-Owned Hospitals (including LTACHs) Safe . . . For Now: SCHIP Bill Passes without Provision Restricting Physician Ownership or Investment Interests

Posted by Jason Greis on February 5, 2009 under Articles | Be the First to Comment

President Obama signed the State Children’s Health Insurance Program bill into law on Wednesday, February 4, 2009, which will eable approximately seven million children to continue to have medical coverage through the program, and which will also allow an additional four million to sign up.   President Obama called the bill “a first step toward fulfilling a campaign pledge to provide insurance for all Americans.”  Read More...

House SCHIP Bill Contains Ban on Physician Ownership and Investment in Hospitals (including LTACHs)

Posted by Jason Greis on January 27, 2009 under Articles | Be the First to Comment

On January 14, 2009 the House of Representatives voted to reauthorize the State Children’s Health Insurance Program (“SCHIP”).  The House version of the SCHIP bill (HR 2) includes a provision contained in Section 623 proposed by House Ways and Means Health Subcommittee Chairman Fortney Pete Stark that would prevent construction of new physician-owned hospitals and restrict the expansion of current physician-owned hospitals by amending certain provisions of the Federal physician self-referral law (commonly known as the “Stark Act”).  Congressman Stark has said that the provision banning future physician ownership in hospitals would prevent the “unethical kickbacks that physicians receive from ownership in hospitals, most of which are of questionable safety and quality.”  This legislation, if passed, would significantly impact current physician ownership and investment interests in LTACHs (e.g., investment by physician joint venture partners) and specialty hospitals and would altogether ban future physician investment and ownership in LTACHs and specialty hospitals. Read More...