HCFA has agreed to postpone one of its requirements for group practices seeking exemption from the "Stark I" Medicare self-referral law.
HCFA will delay a requirement that group members must devote at least 75% of their aggregate patient care through the group practice to qualify for an exemption, the Medical Group Management Association said last week.
The requirement was to take effect Dec. 12.
The MGMA had argued that the condition was unfair and unworkable because it included part-time independent contractors as well as owners and employees as group members. Also, the rule would have required group practices to keep track of physician time both inside and outside of the group.
In a letter to HCFA, the MGMA said the rule would particularly hurt small groups. For example, a group of three full-time primary-care doctors would not qualify for the exemption if it arranges for a dermatologist and an allergist to spend a half-day per week seeing their patients at their clinic, the MGMA said.
The association said HCFA intends to publish a revised rule, possibly in December or January.
Stark I, which became effective in 1993 but had no final rule from HCFA until August, prohibits physicians from referring Medicare patients to clinical laboratories in which they have a financial interest. The law is named after its sponsor, Rep. Fortney "Pete" Stark (D-Calif.).
The 75% test is among several requirements medical groups must meet to qualify for an in-office ancillary exception, which allows them to provide laboratory and other services in their own facilities.
The MGMA prefers a "streamlined" self-referral law contained in the House Medicare reform bill. It would amend the Stark law to define group members as owners and employees only, among other changes.
Randy Teach, director of the MGMA's Washington office, said there are other areas of HCFA's Stark regulations that are "equally if not more ambiguous."
The MGMA advised group practices not to alter their arrangements if they meet the 75% test without including independent contractors.