The other federal legislation that is implicated in expanding the services you offer to your patients are the anti-kickback provisions of the Social Security Act. This law provides criminal penalties for offering, asking, paying or accepting remuneration, in cash or in kind, for referring a patient for services payable by Medicare. In this situation, if the ancillary services are structured through a separate entity, you can very easily run afoul of the federal anti-kickback provisions. As with Stark II, there are several narrowly drawn exceptions to the general prohibition known as safe harbors. Finally, many states also have anti-kickback provisions that are similar to the ones contained in the Social Security Act.
Some states also have anti-referral legislation in varying degrees.
For instance, while Act 66 in Pennsylvania allows a doctor to refer a patient to an entity in which he or she holds a financial interest, the financial relationship must be fully disclosed to the patient. Physicians need to be aware that the regulations are out there and that, at the very least, they will influence ownership structure and how profits are allocated. However, due to the complexity of the regulations, it is advisable that you consult with an attorney who has extensive experience and knowledge of the regulations before implementing the arrangement. Adrian Scipione, Esq. Learn the Business of Medicine online with a Physician's MBA from Regis University.