The rule change, which goes into effect on Oct. 1, would extend the definition of a self-referral entity to include those providing services to Medicare instead of the current definition which only includes the party that bills Medicare for services, according to the report.
The group provided cardiac catheterization services to local hospitals through the labs owned by the physicians. The hospital has no ownership interest in the labs and would bill Medicare for the services and pay the labs a flat fee, according to the report. Under the new CMS rules, this arrangement would be prohibited.
The physicians sued the U.S. Department of Health and Human Services saying that the rule change, violated the Stark law, which allows exceptions if the arrangements meet certain criteria, according to the report. The U.S. District Court said it had no authority to rule because Medicare rules required an administrative appeal.
Read the AMNews report about the federal District Court’s rejection of the physician CMS rule change challenge.
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