CMS Posts Revision to Stark Law

[Sources: Health and Life Sciences Daily, August 28, 2007]

Modern Healthcare (8/28, Blesch) reports that the CMS "has posted to its Web site the long and anxiously awaited final rule that interprets the Stark law prohibitions and exceptions governing referrals that physicians make to entities in which they have a financial stake." In its summary, the CMS writes, "In general, in response to public comments, in this Phase 3 final rule, we have reduced the regulatory burden on the healthcare industry." Modern Healthcare continues, "Healthcare lawyers scrutinized the 516-page document (pdf) as soon as it appeared. ... One hot spot is the fate of what for six years has been a fairly broad exception for indirect compensation, which protects arrangements in which payment flows to a professional corporation rather than directly to physicians." Under Phase 3, "many arrangements that used to be considered indirect will be looked at as direct, making it much more difficult to structure them as safe under Stark. The section pertaining to indirect compensation includes a grandfather clause that allows the terms of current contracts to play out before they would have to be restructured."

Update from Health Lawyers Weekly (here)

TN Definitions: Nurses vs. Physician Assistants

A “physician assistant” is an individual who renders diagnostic or therapeutic services that constitute the practice of medicine and that, but for the provisions of Tenn. Code Ann. §§ 63-6-204 and 63-9-113, could only be performed by a licensed physician. Tenn. Code Ann. § 63-19-102(5). A “certified nurse practitioner” is a registered nurse who is certified by the Board of Nursing pursuant to Tenn. Code Ann. §§ 63-7-123 and 63-7-207(14), and who has been issued a certificate of fitness by the Board of Nursing. Tenn. Comp. R. & Regs. 0880-6-.01(1). An “advanced practice nurse” is a registered nurse with a master’s degree or higher in a nursing specialty and national specialty certification as a nurse practitioner, nurse anesthetist, nurse midwife, or clinical nurse specialist. Tenn. Code Ann. § 63-7-126(a).

Readings on the Regulation of Nonphysician Providers

For a comprehensive analysis of the legal issues relating to nonphysician providers, see Lori B. Andrews, The Shadow Health Care System: Regulation of Alternative Health Care Providers, 32 Hous. L. Rev. 1273 (1996).

Readings on Telemedicine

For an analysis of the Federation of State Medical Boards' Model Act to Regulate the Practice of Medicine Across State Lines (1996) and telemedicine in general, see

Center for Telemedicine Law, Telemedicine and Interstate Licensure: Findings and Recommendations of the CTL Licensure Taks Force 73 N.D.L.Rev. 109 (1997);

Alison M. Sulentic, Crossing Borders: The Licensure of Interstate Telemedicine Practitioners, 25 J. Legis. 1 (1999).