Stark General Exception

Remuneration for furnishing designated health services (DHS) which are ancillary to the referring physician’s core medical practice (excluding most but not all DME) if the services at issue are:
 

  1. Furnished by or under the supervision — at a level that satisfies applicable Medicare supervision requirements — of the referring physician herself, a member of the referring physician’s group practice, or an independent contractor physician who is furnishing patient care services to the referring physician’s group;

  2. Furnished in either the “same building” as that in which the referring physician (or a member of the referring physician’s group practice) furnishes physician services unrelated to the furnishing of DHS or in a “centralized” off-site location that is owned or leased and used exclusively on a full-time basis by the referring physician’s group; and

  3. Billed by the referring physician, the referring physician’s group, an entity wholly owned by the referring physician or by her group, or by an independent third-party billing company acting as an agent for any of the foregoing (provided Medicare reassignment rules are followed).

See www.starkgrouppractice.com for more information about Stark-compliant physician group practices.

9. Physician Investments in Their Own Practices/In-office Ancillary Services

Sources: 42 C.F.R. § 411.355(b) and 42 C.F.R. § 411.352