NEW in office ancillary alternate supplier notification rule

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]

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.