STARK BASIC TRAINING - The American Health Lawyers Association

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IOAS EXCEPTION Who May Provide Services? • Referring physician; • Physician who is member of same group practice as referring physician; • Individuals who are directly supervised by physician or another physician in same group practice; and • Physicians in the group practice such as employees and independent contractors of group practice 71 IOAS EXCEPTION Where Are Services Provided? Same building or Centralized building 72 36
IOAS EXCEPTION Where Are Services Provided? • “Same Building” where referring physician (or others in group) furnish services unrelated to the furnishing of DHS • Building must have a single street address assigned by the U.S. Postal Service, not including interior loading docks, mobile vehicles, vans or trailers • Must meet one of three tests 73 IOAS EXCEPTION Same Building Tests • 1) Office is open to the group’s patients for medical services at least 35 hours per week and a member of the group provides physician services (including non-DHS services) to patients at least 30 hours per week • 2) Referring physician’s group owns or rents an office that is normally open to patients for medical services at least 8 hours per week and referring physician provides physician services (include non-DHS services) to patients at this office at least 6 hours per week • 3) Referring physician’s group owns or rents an office that is normally open to patients for medical services at least 8 hours per week, either referring physician orders DHS services while seeing the patient on the premises or a member of referring physician’s group practice is on premises when DHS is performed and referring physician or member of group practices at site at least 6 hours per week 74 37
Page 1 and 2: STARK BASIC TRAINING Health Care Co
Page 3 and 4: THE SOLUTION: MULTIPLE STATUTES •
Page 5 and 6: WHAT’S NOT PROHIBITED • Physici
Page 7 and 8: THREE QUESTIONS 1. Is there a refer
Page 9 and 10: IMPUTED REFERRALS • Consulting ph
Page 11 and 12: WHAT’S NOT A REFERRAL • Request
Page 13 and 14: DESIGNATED HEALTH SERVICES (Not eve
Page 15 and 16: RESOURCES • 1877(h)(6); 411.351
Page 17 and 18: ENTITY • Multiple DHS entities ca
Page 19 and 20: DIRECT DOCTOR DHS ENTITY (No interv
Page 21 and 22: ICA EXCEPTION • Compensation must
Page 23 and 24: “STAND IN THE SHOES” Physician
Page 25 and 26: RESOURCES • 1877(a)(2), (h)(1)
Page 27 and 28: “SERVICE-BASED” EXCEPTIONS •
Page 29 and 30: FMV RESOURCES • Phase I (pp. 944-
Page 31 and 32: GROUP PRACTICE CRITERIA • Group p
Page 33 and 34: GROUP PRACTICE CRITERIA • Share o
Page 35: 69 IN-OFFICE ANCILLARY SERVICES EXC
Page 39 and 40: IOAS EXCEPTION How Are Services Bil
Page 41 and 42: RECRUITMENT • Payments made to in
Page 43 and 44: PSA EXCEPTION • Arrangement is se
Page 45 and 46: RENTAL EXCEPTIONS • Lease is in w
Page 47 and 48: EMPLOYMENT EXCEPTION • Employment
Page 49 and 50: Non-Monetary Compensation Exception
Page 51 and 52: NON-MONETARY COMPENSATION EXCEPTION
Page 53 and 54: MEDICAL STAFF INCIDENTAL BENEFITS E
Page 55 and 56: TIPS • Always draw a diagram •

STARK BASIC TRAINING - The American Health Lawyers Association

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