CMS aims to fill Stark Law loopholes with new joint venture rules
Medical Staff Briefing, October 1, 2009
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This change will affect many hospitals engaged in joint venture arrangements given the way that many of those arrangements are structured, says Bruce Armon, an attorney with Saul Ewing LLP in Philadelphia. In many joint ventures, one party provides a service and the other party bills Medicare. The Stark changes indicate that the party that provides the service must be the one to bill for the service.
CMS issued this change to close a loophole that allowed parties involved in business arrangements to bundle up the services they are prohibited from billing Medicare and Medicaid for, sell the package to another provider, and then refer patients to that other provider for a slice of the pie. “What Stark is saying now is that you cannot achieve indirectly what you are prohibited from doing directly,” says Alice Gosfield of Alice G. Gosfield & Associates in Philadelphia.
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Medical Staff Briefing.
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