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HHS/CMS

RIN: 0938-AG80

Publication ID: Spring 1996

Title: Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships--Expanded to Designated Health Services (BPD-809-P)
Abstract: This proposed rule would provide that a physician who has (or has a family member who has) a financial relationship with a health care entity may not make referrals to that entity for certain services (designated health services) under the Medicare program, except under specified circumstances. This proposed rule would also deny payment to a State for expenditures for designated health services furnished on the basis of a physician referral that, all things being equal, would result in denial of payment under Medicare. The provisions of the proposed rule are based on sections 13562 and 13624 of the OBRA '93, as amended by SSA '94.
Agency: Department of Health and Human Services(HHS)	Priority: Other Significant
RIN Status: Previously published in the Unified Agenda	Agenda Stage of Rulemaking: Proposed Rule Stage
CFR Citation: 42 CFR 411
Legal Authority: 42 USC 1302 42 USC 1395hh 42 USC 1395nn

Timetable:

Action	Date	FR Cite
NPRM	10/00/1996

Regulatory Flexibility Analysis Required: Yes	Government Levels Affected: State
Small Entities Affected: Businesses
Included in the Regulatory Plan: No
Agency Contact: Betty S. Burrier Department of Health and Human Services Centers for Medicare & Medicaid Services S3-02-01, Office of Chronic Care Insurance Policy, Bureau of Policy Development, 7500 Security Boulevard, Baltimore, MD 21244-1850 Phone:410 786-4649