New CMS anti-referral rules tighten knot on leasing arrangements

August 12, 2008 New CMS anti-referral rules tighten knot on leasing arrangements H. A. Abella -------------------------------------------------------------------------------- Following its charge to reduce costly imaging overutilization, the Centers for Medicare and Medicaid Services has announced more stringent prohibitions against self-referral practices. Final Stark rules for the Hospital Inpatient Prospective Payment System for 2009 could force providers to restructure numerous space and equipment arrangements. Changes to Stark law regulations had anticipated since CMS discussed some proposals in its 2008 rule. Medicare had then noted that more than 1000 comments had provided enough input to implement future regulations without further discussion. The new provisions broaden the definition of Designated Health Services (DHS) "entities" and prohibit under-arrangements and "per-click" arrangements for space and equipment leases.

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