The Stark law generally prohibits physicians from referring Medicare patients for Designated Health Services ("DHS") to an entity the physician or immediate family member has a financial relationship with, unless an exception applies.
Under Stark, there is an exception known as the Non-Monetary Compensation ("NMC") exception (42 C.F.R. 411.357(k) that allows DHS entities that are the recipient of Medicare DHS referrals to provide certain non-cash items or services to a physician, up to $398 for 2017. This dollar amount threshold is adjusted each year for inflation.
Often times, hospitals and other recipients of Medicare DHS referrals seek to give physicians or other referral sources certain items or services as a way to express appreciation or otherwise recognize their services. Under the NMC exception, such items must be tracked throughout the year so that the recipient of Medicare DHS referrals does not exceed the $398 limit for 2017 and therefore violate the Stark law.
Learning Objectives:
- Understanding the interplay between the Stark Law and the Non-monetary Exception
- Analysis required determining if the non-monetary compensation fits within that exception or other exceptions to Stark
- Knowing which items/services qualify and do not qualify for tracking purposes for Non-monetary Compensation
- How to consistently communicate and monitor non-monetary compensation throughout the year
- Applying the Non-monetary Compensation exception to real world scenarios
- Insights and tips for communication strategies with organizational leaders who may provide Non-Monetary Compensation to ensure compliance
Why Should You Attend:
This presentation will cover the logistics for tracking NMC and will walk through several different case scenarios to identify common forms of NMC to determine if such items or services qualify as NMC or how to apportion value for tracking purposes. It will also address corrective action measures if the recipient of Medicare DHS referrals exceeds the dollar amount threshold.
Topics
- Overview on the Stark Law
- Non-Monetary Compensation Exception
- Medical Staff Incidental Benefits Exception
- Discussion on what items/services qualify for Non-monetary
- Compensation
- Discussion on items or services that do not qualify as Non-Monetary
- Compensation
- Strategies for tracking Non-Monetary Compensation throughout the year
- Insights and tips for communication strategies with organizational
- leaders who may provide Non-Monetary Compensation to ensure compliance
- Questions and Answers
Instructor
Jay Anstine is the President of Bluebird Healthlaw Partners, LLC. As a healthcare lawyer specializing in regulatory compliance, Mr. Anstine consults to physicians, senior management and boards of directors on compliance programs and regulatory issues impacting operations.
Mr. Anstine's professional background includes working on the provider and the payer side of the market, for large for-profit and non-profit health systems and small physician-owned entities. In tackling the countless regulatory and operational issues for these diverse organization types, he has developed a deep understanding of the business of healthcare and the regulations that govern the industry.
Mr. Anstine obtained his law degree from the University of South Dakota where he focused exclusively on healthcare law. He currently serves on the Board of Directors for ClinicNET, a non-profit organization in Colorado that serves the medically underserved. He is also a member of the Health Care Compliance Association, serving on the planning committee for the Mountain Regional Conference.