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2006 proposed rule includes nuclear medicine-Stark prohibition

Physician Practice Advisor, August 24, 2005

CMS' Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006: Proposed Rule includes a proposal to make nuclear medicine a Designated Health Service (DHS). As a DHS, nuclear medicine would be covered under the Stark self-referral law, which prohibits examining physicians from providing DHS to their patients.

The Stark rule already covers many radiology procedures. In 2001, nuclear medicine was excluded from the rule because the CMS believed most nuclear medicine was being practiced in hospitals, which were already covered by Stark.

"We believe nuclear medicine services (both diagnostic and therapeutic services and supplies) pose the same risk of abuse that the Congress intended to eliminate for other types of radiology, imaging, and radiation therapy services and supplies," said the CMS in the proposed rule.

For a PDF of the proposed rule, click here.

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