The CMS said it will delay for one year the so-called stand-in-the-shoes provision in the final rule implementing Stark law prohibitions against physician self-referral, but only as applied to academic medical centers and not-for-profit integrated health systems. The rest of the rule, known as Stark III, goes into effect Dec. 4.
The change would have significantly tightened an exception that has been granted to indirect financial relationships between physicians and the hospitals to which they refer patients for certain services reimbursed by Medicare. The physicians, under the new rule, would be considered to stand in the shoes of their practice.
The reprieve was prompted by comments arguing it would be impossible to structure support payments that are routine in faculty-practice plans and not-for-profit systems while meeting the requirements of other Stark exceptions, according to the rule put on display by the Federal Register and expected to be published Nov. 15. -- by Gregg Blesch
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