Tim,
To date, modification of that aspect of the Stark rules has not been promulgated among the various rules providing for additional regulatory during the Federal health emergency. But there is a way that the tests can be interpreted off site of the referring physician's office and still comply with the Stark rules. This is for them to bill the PC as an anti-markup test.
As you note, the Stark rules ordinarily require the professional component service by an independent contractor billed by a group where the referring physician is an owner to be provided on site of the referring physician group. However,
the definition of "entity" in the Stark rules include this carve out.
"(3) For purposes of this subpart, ''entity''
does not include a physician's practice when it bills Medicare for the technical component or professional component of a diagnostic test for which the anti-markup provision is applicable in accordance with § 414.50 of this chapter and section 30.2.9 of the CMS Internet-only Manual, publication 100–04, Claims Processing Manual, Chapter 1 (general billing requirements)."
Thus, if the referring group bills the PC as an anti-markup test, it is exempted from Stark since the referral of a DHS service that is billed as an anti-markup test is not a referral to an "entity" in which the referring physician has an ownership interest.
Thomas W. Greeson
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tgreeson@reedsmith.com
Reed Smith LLP
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