Health Care Reform

Buried deep in the CMS final rule with comment period on Hospital Outpatient and Ambulatory Surgery Center payments are a few modifications to the federal rules regarding expansion of physician-owned hospitals, physician self-referral prohibitions, and patient notification requirements.

The document mostly addresses the processes for a physician-owned hospital to request exemptions to restrictions on self-referral and expansion, and also summarizes comments that the CMS received on proposals it made in July.

The rule also includes provisions noting that physician-owned hospitals must not “discriminate against beneficiaries of federal healthcare programs” or “permit physicians practicing at the hospital to discriminate against such beneficiaries,” and specifying that any permitted capacity increases must not result in a hospital increasing its number of licensed operating rooms, procedure rooms, and beds by 200%.

The rule also clarified patient-notification regulations that mandate how “dedicated emergency departments “must conspicuously post notices if a facility does not have a physician on site 24 hours a day, 7 days a week.  CMS stated that medical residents would qualify as “physicians” and that the notification would apply to all hospitals, not just physician-owned hospitals.

Another change is that inpatients and outpatients who receive observation services, surgery, or services involving anesthesia must be given written notice that a hospital may not have a physician on-site 24 hours a day, and that this notification must be followed by a signed acknowledgment from the patient of this fact.

For more information on any of the above, contact Thomas N. Hutchinson at thutchinson@kdlegal.com or (317) 238-6254