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12/1/2007
Stark II, Phase III Changes Take Another Swipe at Ancillary Services
Nashville Medical News

Related Attorney(s):   John B. Hardcastle

Boult Cummings health care attorney, Jay Hardcastle, comments on the new Stark II, Phase III final rules. One of the provisions will influence the financial relationships between physicians and the health care entities to which they refer patients.

"These Stark rules get super technical and start to look like IRS tax rules when you try to figure out how you need to treat a relationship between a referring physician and something to which the physician sends business," Hardcastle said.

The final rules will also affect physician recruitment procedures. More specifically, the rules will impact noncompete agreements. In the past, the Centers for Medicare and Medicaid Services (CMS) have been against recruiting dollars going to physicians who sign a noncompete. These dollars are considered lost to the community if the physician leaves the hospital.

With the new rules, CMS will only allow a non-compete agreement "as long as it is reasonable and certain other technical requirements are met," Hardcastle explained.

An anti-markup rule has also been introduced and will take effect Jan. 1. This rule is meant to prevent practice groups from marking up outside professional advice. However, it will also affect physician groups who have their own in-office ancillary services.

"CMS has basically announced that they're trying to make it very, very hard for physicians to make money on in-office ancillary services," Hardcastle said.


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