Issue link: https://beckershealthcare.uberflip.com/i/1412867
56 HEALTHCARE NEWS Profit sharing, productivity bonuses for physicians: 7 Stark Law updates By Laura Dyrda C MS clarified the rule allowing in-office ancillary service referrals without violating Stark Law and announced changes that will take effect Jan. 1, 2022. e agency prohibits physicians from referring patients to their practices for designated health services, but does offer exceptions if the practice distributes profits appropriately. CMS' Dec. 2 update included a section focused on productivity bonuses and profit sharing for medical groups, as outlined in legal publisher JDSupra. Seven things to know: 1. CMS doesn't allow "split-pooling," in which practices develop profit distribution pools based on service lines. e rule will require groups that currently have "split-pooling" distribution models for designated health services profits to revise compensation methodologies by the end of the year. 2. e rule clarifications imply physicians can only receive profits from a single distribution pool, ac- cording to JDSupra. 3. Physician practices can segment groups of five or more physicians by specialty, location, full or part-time status, and tenure, among other criteria, for profit sharing if the groups are not related to the physicians' referral volume or value. 4. CMS clarified that physician practices don't have to distribute all profits from designated health services. 5. Physician practices can treat physician distribu- tion groups differently for profit sharing, and can use separate distribution methods for each group. 6. Practices are required to use a single distribu- tion method for all physicians within a distribu- tion group. 7. CMS will allow practices to distribute all profits to distribution groups with less than five physi- cians if the practice meets exemption require- ments and aggregates all designated health services profits before distribution. n Top 10 ways physicians earn secondary income By Laura Dyrda O ne-third of physicians who responded to Medical Economics' salary, productivity and profession survey reported collect- ing secondary income last year. The survey, published June 3, shows the number of physicians with secondary income increased 3 percent year over year, and 17 percent said their second income came from nonmedical work. The average amount of secondary income varied. Pediatric physicians reported the highest secondary income at $62,000, while OB-GYNs reported the lowest, at $38,000. The 10 top most common sources of secondary income were: 1. Consulting 2. Nonmedical work 3. Expert witness 4. Clinical work 5. Medical administrator 6. Speaking 7. Clinical trials and research 8. Emergency department and urgent care work 9. Nonemergency department hospital work 10. Hospice n Watch out doc: 5 worst states for physicians to practice, per Medscape By Laura Dyrda M edscape ranked the five worst states to practice, based on malpractice payouts, compensation, health system perfor- mance and physician happiness. The May 24 report also took into consideration livability and overall health of the population in each state using information from other Medscape surveys, U.S. News & World Report rankings and United Health Foundation's 2020 America's Health Rankings. 1. West Virginia 2. Louisiana 3. New Mexico 4. Nevada 5. Rhode Island n