While the federal physician selfreferral statute (commonly known as the Stark law)1 has significantly restricted the feasibility of many traditional, free-standing physician joint ventures, it has had no such effect on ambulatory surgery centers (ASCs). Subject to certain exceptions, the Stark law prohibits physicians from referring Medicare patients to an entity for certain “designated health services” if the physician has a financial relationship with that entity. ASC services are not, themselves, “designated health services” covered by the Stark law; thus, there are no Stark-based limitations or restrictions on physician ownership of ASCs, as long as the ASC does not provide any separately billable designated health care services. In other words, any “designated health services” (such as clinical laboratory services or outpatient drugs) provided by the ASC must be included within the ASC’s composite rate payments, not billable to Medicare separately.
This article, published in the August issue of Compliance Today, appears here with permission from the Health Care Compliance Association. Please call 888.580.8373 with reprint requests.