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Highlights From Health Care Reform Legislation

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New Disclosure Requirements Under Stark Return Us to the Indenbaum Era
Alan G. Gilchrist
Foster Swift Health Care Law Report
April 2010

Prior to the amendments to the Michigan Public Health Code, physicians attempted to avoid a broad self-referral ban by providing patients with disclosure of certain ownership interests and advising the patients that they need to seek services elsewhere.

Once the Public Health Code was amended to follow the Stark legislation, these disclosures were not necessary.  Now with the passage of health care reform, they must be reinstituted.

Section 6003 of the health care reform act amends the in-office ancillary service exception under Stark by requiring a referring physician to inform patients in writing, at the time of referral, that the patients may obtain specified imaging services (MRI, CT, and PET), or other diagnostic services as designated by the HHS Secretary from a person other than the referring physician, a physician who is a member of the same group practice as the referring physician, or an individual directly supervised by the physician or by another physician in the group practice.  The provision requires that the referring physician provide the patient with a written list of suppliers who furnish such services in the area in which the physician resides.  This provision is effective for any service provided after January 1, 2010, although physicians could not have complied with the provision until the law went into effect.

It is important to note that the disclosure is required not only when the service is provided by the referring physician or a member of the group, but also when the service is directly supervised by the physician or a member of the group.