First, let's back up and put things in context. When the original Stark law took effect in 1993, it prohibited only referrals to lab services in which referring physicians had financial interests. Further, the entity providing the service may not present a claim for any such service if the referral was from a physician with a financial interest, though, again, exceptions apply. The law prohibits a wide range of financial relationships. Specifically, prohibited financial relationships with a provider are physician ownership or investment interests in the entity, or a compensation arrangement between the physician and the entity.
Some exceptions apply to both the ownership and compensation arrangement prohibitions.
In-office ancillary services. This exception applies to designated services rendered on the premises. This exception has various requirements about physical proximity, supervision, consolidation of resources and billing procedures, to name several. This applies only to ownership. Any compensation arrangement between the referring physician and a rurally designated provider must qualify for one of the compensation arrangement exceptions.