Section 6003 of the health reform act adds an additional sentence to the in-office ancillary services exception contained in the Stark Law. This new provision requires that a physician referring a Medicare, Medicaid, Tricare, or Medicare Advantage Plan (i.e. Federally funded program) patient for in-office ancillary services must provide the patient with a written notice that the patient may obtain such services from a health care provider other than the referring physician. Further, the notice must include other health care providers in the area who also provide such services. As it stands, this provision was made effective retroactively to January 1, 2010, making past compliance impossible. This effective date was not addressed in the reconciliation package to the health reform act. Therefore, this notice requirement is technically currently effective. Hopefully, further guidance from the Secretary regarding the enforcement of this provision will be forthcoming. However you might want to begin implementing the new law in your office.
The following is a sample letter you can put on your letterhead and give out to your Medicare, Medicaid, and Tricare patients and patients enrolled in Medicare Advantage Plans. Please insert the appropriate information where indicated.
Dear Patient:
[Practice Name] provides imaging services ( LIST SERVICES HERE) on site for your convenience. We are happy to provide these services for you, but for your convenience and as required by the recently enacted healthcare reform law, we are providing you with information on other suppliers that you may choose to provide these services to you. These are the local suppliers in our service area:
Local Hospital [INSERT]
Address
City, State, Zip
Local IMAGING CENTER [INSERT]
Address
City, State, Zip
Local Imaging Center [INSERT]
Address
City, State, Zip
Please let us know if you have any questions about this letter.
Sincerely,
[Practice Name]
Have questions? I’m here to help.
