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The “substantially all” test is intended to guarantee that the group practice members are providing a substantial amount of their services through the group. Under the in-office ancillary services exception, DHS must be furnished to patients in the same building where the referring physicians provide their regular medical services, or in the case of a group practice, in a centralized building. Group practices that choose to take advantage of the special treatment that the Stark law affords them must be prepared to demonstrate compliance with relevant statutory and regulatory standards. The in-office ancillary services exception has arguably been the single most important exception in the Stark law. Phase II creates an exception to protect against inadvertent noncompliance with Stark. In response to the Phase I regulations, CMS received many comments regarding physician compensation with a common theme that there should only be one set of conditions applicable to physician compensation.
Notwithstanding these attempts, caution should still be taken when analyzing physician compensation as the specific terms and conditions of each exception continue to differ in some respects. Phase II makes many revisions and clarifications to the academic medical center (“AMC”) exception in order to make it easier to qualify. Phase I of the rulemaking also created new regulatory exceptions for fair market value compensation paid to employees or independent contractors and compensation for academic medical center physicians.
Stark prohibits physicians from referring Medicare/Medicaid beneficiaries to an entity in which they (or an immediate family member) have a financial relationship for DHS. Phase II provides clarification and modifications as to how physicians can be compensated under the various exceptions for physician compensation. You can upgrade to more space and even add two additional drives. We hooked it up to two of our TV's. The water then froze, encasing all 3 of their cars in a thick layer of ice.
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