Stark Law Exemption Deadline Looming for Physician-Owned Hospitals

Physician-owned hospitals that want to keep their “whole hospital” or “rural providers” exceptions to the Federal Stark Law have until December 1, 2013 to report their ownership and investment information to the Centers for Medicare & Medicaid Services (CMS).

The hospitals, according to lawyers from Bradley Arant Boult Cummings LLP, should carefully review their Medicare enrollment files to ensure compliance with a recently imposed reporting requirement. Medicare recently announced that to satisfy the reporting requirement, physician-owned hospitals must report the ownership and investment information as set forth in the Medicare Enrollment Application (Form CMS-855A), which includes a special attachment for such hospitals.

The lawyers say hospitals that submitted this information on or after December 1, 2012 on Form CMS-855A will be considered to have met the December 1, 2013 deadline. To continue meeting reporting requirements, physician-owned hospitals must either update their information or verify that the relevant ownership and investment information in the Medicare Provider Enrollment, Chain and Ownership System is correct on an annual basis.

The Stark Law prohibits a physician from referring Medicare patients for designated health services to an entity with which the physician (or the physician’s immediate family member) has a financial relationship, unless an exception applies. To qualify for either the “whole hospital” or “rural provider” exception, the regulations promulgated under the Stark Law require, among other things, that physician-owned hospitals submit to CMS an annual report containing ownership and investment information at such a time and in such a manner as specified by CMS.

To find the CMS announcement and additional references, go to the following link:

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1332.pdf