pLAn AheAD FOr ChAngeS TO phySiCiAn grOup prACTiCe prOFiT ShAring
Health Care law Section Chairs : Erica Mallon , Greenway Health & Elizabeth Scarola , Epstein Becker & Green , P . C .
The rule includes important changes to how physician group practices may share profits that take effect next year .
The Centers for Medicare & Medicaid Services ( CMS ) recently issued a new rule modernizing the “ Stark Law ” regulations . The rule aims to advance value-based care and ease the regulatory burden on physicians . Most of the reforms are effective January 2021 ; however , the rule includes important changes to how physician group practices may share profits that take effect next year . 1
The Stark Law prohibits a physician from making referrals for certain “ designated health services ” ( DHS ) payable by Medicare to an entity with which the physician ( or an immediate family member ) has a “ financial relationship ,” unless an exception applies . The definition of “ financial relationship ” includes compensation arrangements and ownership interests . The term DHS applies to numerous health care services and supplies , including clinical laboratory services and diagnostic imaging services . 2
Under the Stark Law exceptions , 3 a group practice may pay its physicians a share of “ overall
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