STARK II PHASE II. NORTHWEST HOSPITAL COUNCIL SEPTEMBER 17, 2004 By Bradley J. Berg. CMS issued Phase II of the Stark II final regulations on March 26, 2004 Phase II became effective July 24, 2004. HISTORY. January 1, 1992 Stark I August 14, 1993 Stark I Regulations
NORTHWEST HOSPITAL COUNCIL
SEPTEMBER 17, 2004
By Bradley J. Berg
Examples of ownership or investment interests include:
A request by a pathologist, radiologist or radiation oncologist for certain services if performed as a result of a consultation initiated by another physician and the service is furnished by or under the supervision of the pathologist, radiologist or radiation oncologist
Rural Provider Exception: excludes from the category of ownership or investment interests ownership in an entity if substantially all of the entity’s DHS are furnished to people who live in a rural area.
Urban and Rural Defined:
“Urban Area” is an area within a Metropolitan Statistical Area as defined by the Office of Management & Budget or such similar area as the Secretary has recognized.
“Rural area” is any area outside a Metropolitan Statistical Area or such similar area.
Effective Date of Rural Definition: unclear.
New exception in response to request for a grace period if parties fall out of compliance due to conditions outside their control.
The rule now distinguishes between a recruitment arrangement directly with a recruit and recruitment through another physician or practice.
New limitations on recruitment through another physician or practice.
Arrangement Directly With A Recruit:
A hospital may provide remuneration to a recruit to relocate to the hospital’s geographic area to join its medical staff if:
Geographic Area and Relocate Defined:
“Geographic area” is defined as the area comprised of the lowest number of contiguous zip codes from which the hospital draws 75% of its patients.
“Relocate” means the physician moves his or her practice a minimum of 25 miles or the new practice derives a minimum 75% of its revenue from professional services to patients not treated by the physician in the past three years.
Residents and physicians in practice less than one year are not subject to the relocation requirement.
Recruitment Through Another Physician or Group:
Permits a referring physician to cross-refer to an immediate family member or an entity that has a financial relationship with the family member if certain conditions are met.
Contact information: Bradley J. BergTelephone: 206-447-8970Email: Bergb@Foster.comFoster Pepper & Shefelman PLLC1111 Third Avenue, Suite 3400Seattle, WA 98101