In the 2010 Affordable Care Act, Section 6001 added new regulatory restrictions and requirements for physician-owned hospitals. See 42 U.S.C. § 1395nn(i).
“Physician-owned hospital” means any hospital “in which a physician, or the immediate family member of a physician, has an ownership or investment interest. The ownership or investment interest may exist through equity, debt or other means, and includes the interest in an entity that holds an ownership or investment interest in the hospital.” See 42 C.F.R. § 489.3.
Federal regulations previously provided for the “whole hospital” exception to the Stark Laws. This particular safe harbor required that the referring physician/owner: (1) have a financial interest in the whole hospital, and not just a specific part; (2) be authorized to perform services at the hospital; and (3) be expected to actually perform the agreed upon services. The requirements of Section 6001 substantially modified this exception. See 42 C.F.R. § 411.362.
Under the Affordable Care Act, the whole hospital exception applies only to physician-owned hospitals that had physician ownership as of March 23, 2010, and had obtained a Medicare provider number by the end of 2010. … Read more →