Nicole Liffrig Molife

The Advanced Medical Technology Association, or AdvaMed, released a revised Code of Ethics on Interactions with Health Care Professionals on Dec. 18.

The Advanced Medical Technology Association (AdvaMed) recently released a revised Code of Ethics on Interactions with Health Care Professionals which will become effective July 1. The revised code provides guidance on what conduct is appropriate and inappropriate between the medical technologies industry and health care professionals (HCPs).

On Nov. 18, the Centers for Medicare and Medicaid Services published its final physician fee schedule for 2009 in the Federal Register.

The final Inpatient Prospective Payment System Rule published Aug. 19 contains numerous revisions to the Stark regulations. The Centers for Medicare and Medicaid Services is delaying the enforcement of three key revisions to allow physicians time to restructure their arrangements with hospitals and other providers to comply with the new regulations. Alan E. Reider Allison Weber Shuren The Stark Law prohibits a physician from referring Medicare beneficiaries for designated health services (DHS) to a Medicare provider with which the physician has a financial relationship and the Medicare provider from billing the federal health care program for those referrals, unless an exception applies. DHS includes, among other services, radiology services, laboratory services, and inpatient and outpatient hospital services. If the physician refers any Medicare patients to the hospital or any other DHS entity for DHS, all financial relationships would need to meet an exception to the Stark Law.

On May 12, Baptist Health South Florida, a health care system based in Coral Gables, Fla., entered into an arrangement with the U.S. Department of Justice’s Civil Division and the Office of Inspector General of the Department of Health and Human Services to settle claims that it violated the False Claims Act and the Physician Self-Referral Law. Baptist Health allegedly paid excessive compensation to a community oncology group that referred patients to two of Baptist’s hospitals, in violation of the Stark Law.

Congress is expected to propose more rigorous Medicare payment reforms in 2008, given lightweight Medicare reform legislation that resolved several issues only for a brief 6-month period including a 6-month physician payment fix that it passed in late 2007.

On July 2, the Centers for Medicare and Medicaid Services issued its proposed Medicare Physician Fee Schedule for calendar year 2008, in which CMS proposes numerous reforms to the Physician Self-Referral (Stark Law) regulations and purchased diagnostic test rules. Any proposal that is finalized will go into effect Jan. 1, 2008, and as currently written, there would be no grandfather clause. Given the scope of some of the proposed changes and that there would be relatively little time to come into compliance, physicians and health care organizations are well-advised to review their existing arrangements and determine how they could be affected. A further degree of uncertainty is created by the fact that the long-awaited Stark II/Phase III regulations could be finalized any time in the next several months, and it is not clear exactly which issues Phase III will address.