GOVERNMENTQuality worries trigger renal physicians' Stark II lawsuitThe AMA and other medical organizations in the past have expressed concern over a safe harbor provision that covers end-stage renal disease facilities.By Tanya Albert, amednews staff. Feb. 14, 2005. Renal physicians say a provision in the Stark II interim final rule that applies to medical directors will make it difficult for dialysis facilities to ensure that end-stage renal disease patients receive quality health care, and they've gone to court to try to change it. The Stark II law is designed to prevent doctors from improperly self-referring patients. In addition to outlining unacceptable behavior, the law outlines safe harbors that establish guidelines for what would be acceptable practices. For example, a safe harbor can establish what is fair market value for office space or someone's time. While the Stark II rule was being designed, the government was asked to establish a fair market value benchmark for the compensation of end-stage renal disease facility medical directors. But instead of specifically setting a rate that would apply to them, the government created a safe harbor provision that defined fair market value for hourly payments to physicians for their personal services. Medical director salaries would fall under this provision. The safe harbor offers two ways to calculate the hourly rates that would be a "fair market value." One methodology requires that the medical director's hourly payment be less than or equal to the average hourly rate for emergency department physician services in the relevant market. To calculate the rate this way, the market needs to have at least three hospitals that provide emergency services. The other requires that a facility use four of six approved national salary surveys to calculate an average hourly rate for the specialty. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2005 American Medical Association. All rights reserved.
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