Becker's Spine Review

27 ASC Stark Law: What ASC leaders need to know in 2023 By Patsy Newitt Becker's has reported on three Stark Law changes and considerations in 2022. Here's what ASC leaders need to know going into 2023: Fair market consideration Understanding fair market value is critical for Stark Law compliance. Fair market value opinions are oen based on benchmark data, and CMS has said that fair market value should include the application of both market area issues and physician-specific issues. Commercial reasonableness, which includes whether application of benchmark factors are defensible, is a separate concept to fair market value. When drawing contracts, physicians need to view both fair market value and commercial reasonableness as if advocating in front of a governmental entity, according to an Oct. 20 report from e National Law Review. If the contract is required to be defended, the analysis will need to include references and attachments to all documentation. Physician compensation arrangement change Hospitals and health systems need to update their physician compensation plans aer CMS' recent changes to the Stark Law. Here are three things to know about the updates: 1. Physician compensation plans where productivity is above the 75th percentile could trigger review. ese plans should ensure that compensation is consistent with the physician's personal productivity. 2. Compensation should also be consistent with the services performed by the practitioner. If a physician is compensated based on their advanced practice providers' work relative value units, for example, hospitals should ensure that compensation is explicitly for the services performed by the physician. 3. Indirect compensation agreements should be reviewed, because certain compensation agreements that consider APP work relative value units as physician compensation might not meet both commercial reasonableness and fair market value tests. Stark Law disclosure protocols CMS is considering changes to its Stark Law voluntary self-referral disclosure protocols in an effort to streamline the process, according to a July 14 article in JDSupra from the law firm McGuireWoods. e voluntary protocol is a way to resolve technical violations under the physician self-referral law by submitting information to CMS about prohibited conduct. e change would limit the required disclosure information to a single form per disclosure instead of separate forms for each physician involved in a group practice. e streamlined process would allow group practices to answer the physician information form questions for all physicians collectively, rather than an individual form for each physician. n Amazon clears hurdle in One Medical deal: What ASCs should know By Patsy Newitt T he Oregon Health Authority has approved Amazon's proposed acquisition of One Medical, clearing a hurdle to cementing the deal. The authority's regulatory review found that Amazon purchasing One Medical likely wouldn't "substantially" lower access to care in the state, The Seattle Times reported Dec. 28. However, health equity concerns could arise if One Medical steers commercially insured patients with higher pay rates away from clinics that also serve the Medicare and Medicaid populations. Amazon and One Medical are still waiting for federal approval to close the deal. The deal could raise costs for all medical groups and further alter the dynamics of physician recruiting and acquisitions, according to a Forbes report. Independent physicians should be prepared for "an entirely new dynamic" when it comes to prospective buyers, the report said. The new market will include unconventional buyers, such as larger retail companies. There will also be a push toward consolidation as more buyers look to buy physician practices. n Wisconsin physician's license suspended for falsifying immunization records By Hayley DeSilva S cott Stillwell, MD, of Green Bay, Wis., had his license suspended for 30 days after falsely recording that he and his immediate family were vaccinated against COVID-19, the Green Bay Press- Gazette reported Jan. 9. Dr. Stillwell was found to have used a medical assistant's credentials to access the Wisconsin Immunization Registry, where he denoted receiving the vaccine from the clinic he practiced at in 2021. The false records were discovered in January 2022, and Dr. Stillwell resigned from the practice the next month. His license was officially suspended by the state's Medical Examining Board Dec. 21. Dr. Stillwell claimed he and his family had developed natural immunity, according to the examiner office orders obtained by the publication. His license will be reinstated Jan. 21. He has been ordered to complete three hours of professional ethics courses and pay a fine of $1,062. n

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