Diagnostic Imaging Intelligence Report

On July 31, 2008, the Centers for Medicare and Medicaid Services (CMS) released the final 2009 inpatient physician fee schedule rule (the final rule), which included a number of important revisions to the Stark law. Most notably, these changes will make it increasingly difficult for a hospital or health system (or other corporate partner) and referring physicians to collaborate in an imaging center, ambulatory surgical center, cancer center, cardiac catheterization lab, and other types of outpatient joint ventures. Specifically, the rule changes tackle "under arrangement" transactions and other turn-key management arrangements involving referring physician ownership in a management company, as well as transactions that involve a variable fee that is based on a per-unit or percentage-based fee component.