This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
What is Stark III?
The Centers for Medicare and Medicaid Services provided a partial listing of Phase III changes in the final rule published in the Federal Register of September 5, 2007.
Notable Changes in Stark II, Phase III
- Eliminates the safe harbor proposed in Phase II within the fair market value definition for physician compensation;
- Considers a physician to "stand in the shoes'' of a physician organization of which he or she is a member;
- Clarifies that an independent contractor physician is a "physician in a group practice" when under a contractual arrangement directly with the group practice and is performing services in the group practice's facilities;
- Permits group practices to impose certain practice restrictions on recruited physicians;
- Clarifies that group practices can determine productivity bonuses by directly taking into account the volume and value of items and services that are provided "incident to'' the physicians' professional services, in certain circumstances;
- Adds a 45-minute transportation time test as an alternative to the 25-mile rule to the intra-family rural referrals exception;
- Adds a holdover provision in the exception for personal service arrangements;
- Clarifies that a "rural area," a location not included in the Metropolitan Statistical Areas (MSA), may be a micropolitan area. (See the MSA listing at the Office of Management and Budget to determine MSA status.)
- Expands the geographic area into which a rural hospital may recruit a physician;
- Permits a more generous income guarantee under certain circumstances in the case of a physician who is recruited to replace a deceased, retiring or relocating physician;
- Revises the nonmonetary compensation exception to allow physicians to repay certain excess nonmonetary compensation within the same calendar year to preserve compliance;
- Allows an entity with a formal medical staff to provide one local medical staff appreciation event per year;
- Clarifies that a hospital may list a physician's name on it's web site or in advertisements as a medical staff incidental benefit but physician payments for referral services must be within both an exception and an anti-kickback safe harbor;
- Adds a written certification option as an alternative to the requirement for a bona fide written offer under the exception for retention payments in underserved areas.
- Expands the exception for retention payments in underserved areas to permit retention payments to be made in the case of a physician who certifies that he or she has a bona fide opportunity for future employment and the arrangement satisfies all other conditions of the exception.