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HHS/CMS RIN: 0938-AG80 Publication ID: Fall 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 
Major: No  Unfunded Mandates: No 
EO 13771 Designation: uncollected 
CFR Citation: 42 CFR 411   
Legal Authority: 42 USC 1302    42 USC 1395hh    42 USC 1395nn   
Action Date FR Cite
NPRM  04/00/1997    
Additional Information: BPD-809
Regulatory Flexibility Analysis Required: Yes  Government Levels Affected: State 
Small Entities Affected: Businesses 
Included in the Regulatory Plan: No 
Agency Contact:
Joanne Sinsheimer
Technical Advisor
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare Management, Chronic Care Policy Group, C4-25-02, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-4620