Several revisions have been proposed to the 2016 Medicare Physician Fee Schedule, including a new exception to the regulations under the federal physician self-referral law, commonly referred to as the Stark Law.
Responding to concerns about the shortage of available primary care services, the CMS is proposing a new exception for assistance in employing “non-physician practitioners,” or NPPs, as well as clarifications for Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) service areas. If finalized, the exception could be an opportunity for hospitals, FQHCs, and RHCs to assist medical practices in hiring non-physician practitioners to enhance primary care services delivery.
CMS also is seeking to revise the “In Writing” requirements of the Stark Law. This revision would clarify that when Stark Law exceptions require writings for compliance, that writing does not have to be a formal agreement or a single document.
A “collection of documents, including contemporaneous documents evidencing the course of conduct between the parties, may satisfy the writing requirement of the leasing exceptions and other exceptions that require that an arrangement be set out in writing,” CMS says.
Compliance with current Stark Law requirements for compensation arrangements has been called burdensome to physicians and entities that provide designated health services (DHS).
Persistent questions about whether timeshare arrangements violate the Stark Law could be cleared up with the CMS proposal for a new exception that would protect timeshare arrangements in which a hospital or physician organization licenses the use of space, equipment, personnel, items, and supplies to a physician licensee. Under the new exception, CMS would deem that substantially all of the services furnished to patients on the licensed premises are not DHS. The only permissible DHS are services that are incidental to the patient’s evaluation and management visit, and furnished contemporaneously with that visit.
The CMS proposal is available online at http://tinyurl.com/q78chgr.
