The Ethics in Patient Referrals Act, commonly known as the Stark law, generally prohibits physicians from referring Medicare patients for designated health services ("DHS") to an entity the physician or immediate family member has a financial relationship with, unless an exception applies.
Under the Stark law, there is an exception known as the Non-Monetary Compensation (NMC) exception (42 C.F.R. 411.357(k) that allows entities that are the recipient of Medicare DHS referrals to provide certain items or services of value to a referral source, such as a physician, up to $392 for 2016. This dollar amount threshold is adjusted each year for inflation. The item(s) or service(s) must not be in the form of cash or a cash equivalent.
Often times, hospitals and other recipients of Medicare DHS referrals seek to give physicians or other referral sources certain items or services as a way to thank the referral source for their services or recognize them for a job well done. A common example would be giving all physicians on the medical staff at a hospital a flower arrangement or cookie tray to say thank you. Under the NMC exception, such items must be tracked throughout the year so that the recipient of Medicare DHS referrals does not exceed the $392 limit for 2016 and therefore violate the Stark law.
Join expert speaker Jay P. Anstine, JD, in this session where he will cover the nuts and bolts for logistically tracking NMC and will walk through several different case scenarios to identify common forms of NMC to determine if such items or services qualify as NMC. It will also address corrective action measures if the recipient of Medicare DHS referrals exceeds the dollar amount threshold.
Who should attend?
Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.
Jay P. Anstine, J.D., is the President of Bluebird Healthlaw Partners, LLC. As a healthcare lawyer specializing in regulatory compliance, Jay consults to physicians, senior management, and boards of directors on compliance programs and regulatory issues impacting operations.
Jay’s professional background includes working on the provider and the payer side of the market, for large for-profit and non-profit health systems, and small physician-owned entities. In tackling the...
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