Ensuring Stark and Anti-kickback Compliance in Providing EHR and e-Prescribing to Physicians

1. Stark and Anti-kickback Protections for Giving EHR and e-Prescribing to Physicians Website Slides Alice G. Gosfield c.2006 Alice G. Gosfield

2. Who can give • Electronic prescribing: Same • Hospital to member of medical staff • PDP sponsor or MA organization • Group practice to a “member” • EHR: • Those plus, an ‘entity’ under Stark; • For AKS – any entity which provides services and submits claims under a federal health care program c.2006, Alice G. Gosfield

3. Who can receive • A physician on staff of a hospital as long as eligibility does not take into account volume or value or referrals • Things that are OK to consider: • Total # of scripts; size of practice (e.g., # of pts, pt encounters, or RVUs); total # of hrs physician works; overall use of automated technology in the practice; level of uncompensated care physician renders • Any other reasonable and verifiable judgment not reflective of volume or value of referrals c.2006, Alice G. Gosfield

4. What can be given • Electronic prescribing items and services • Hardware, software or information technology, training services “necessary and used solely to receive and transmit electronic prescription info” • Electronic health records • Software or IT and training “necessary and used predominately” for HER – no hardware c.2006, Alice G. Gosfield

5. Conditions for Prescribing IT:Written Agreement and More • System meets Part D standards • Donor does not limit or restrict use or compatibility with other electronic or EHR systems • System can be used for any patient • Receipt of system is not a condition of referrals by recipient • Donor has no knowledge or does not act in reckless disregard or deliberate ignorance of whether the physician has equivalent services or items c.2006, Alice G. Gosfield

6. Conditions for EHR: Written Agreement and More • Software is interoperable as certified no more than 12 mos before by proper agency • No limitations on uses with other IT • Before receipt, physician pays 15% of donor’s cost for items or services • No donor loans for the payment • Recipient doesn’t condition receipt on referrals • No donor knowledge of physician’s having equivalent IT c.2006, Alice G. Gosfield

7. EHR Conditions (2) • Can be used for all patients • Donation does not include staffing of physician offices and is not used primarily for personal business or business unrelated to the medical practice • The software contains electronic prescribing capability or the ability to interface with the physician’s electronic prescribing system c.2006, Alice G. Gosfield