Yet More Changes to the Stark Law Regulations

Abstract

a t [ n August 19, 2008, the Centers or Medicare & Medicaid Services CMS) issued the Hospital Inpatient rospective Payment System final ule for discharges in fiscal year 2009. lthough technically speaking, it ay not be called the Stark II, hase IV regulations, what it lacks n name it undoubtedly makes up or in substance. CMS has used the 009 final rule to adopt a number f important changes and clarificaions to the Stark law regulations on he basis of proposals in the Hospital npatient Prospective Payment Sysem proposed rule for discharges in scal year 2009, as well as proposals n the 2008 Medicare Physician Fee chedule (MPFS) proposed rule that ere not addressed in the 2008 PFS final rule. This newest round f changes is by far more reaching han any of the changes implemented y CMS in the Stark II, Phase III egulations issued last year. The Stark-related changes and larifications contained in the 2009 nal rule are, generally speaking, efective October 1, 2008. Certain f the changes, however, such as he provisions prohibiting comon “under arrangements” transctions, percentage-based lease payents, and per-unit leases, are not ffective until October 1, 2009, in n effort to give providers time to estructure or unwind existing arangements that currently do not comly with the new changes. This article eviews the Stark-related changes nd clarifications that may be of interst to radiologists, beginning first with he changes that are effective October , 2009, because these are the changes hat potentially will have the greatest t