In a recent “Fierce Healthcare” article, the following three laws should be considered by both hospital physicians and physicians placed in hospitals, through outsourced physician services.
• The Stark Law prevents a physician from making patient referrals to organizations in which he or she has a financial relationship. But there is an exception to the rule if the hospital’s compensation to the management company is steady and doesn’t vary with patient volume or referrals, according to the article.
• The Anti-kickback Statute prohibits payment for referrals for reimbursable services. If the hospital offers the medical staff member an opportunity for ownership interest in the management company, it may violate the Anti-kickback Statute.
• The Civil Monetary Penalties Statute prevents a hospital from paying a patient care provider to stop services to those patients who are entitled under federal benefits. This means that physicians need to be careful that efforts to meet quality benchmarks do not violate the statute.
According to the article “because a co-management agreement involves the payment of compensation to physicians who refer patients to the hospital, the arrangement must be structured properly in order to avoid violation of applicable healthcare statutes and regulations.”