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Financial relationships can include either compensation or investment arrangements.
A violation of the Act results in nonpayment of claims, recoupment of overpayments, and potential monetary sanctions. Part One of the new rule, itself some 600 pages long, addresses the general prohibition on referrals and the exceptions that pertain to both ownership and compensation relationships. Part Two will tackle ownership and investment exceptions and should be released shortly. According to HCFA, the new rule is intended to address some of the criticisms leveled against the proposed rule issued in 1998. Those criticisms included assertions that the proposed rules were inflexible and caused undue disruption of health care delivery systems, limited or prohibited potentially beneficial financial arrangements between health care providers, were out of step with the current trend toward integration, and created the double threat of vague, confusing standards combined with potentially significant financial consequences to health care providers.