decisionhealth Newsletters, Part B News - 2014 Issue 11 (November)
Avoid compliance headaches; update your list of services covered by Stark rule
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Article Overview
This article explains updates to the list of services affected by the Stark Physician Self-Referral rule as reflected in the 2015 Medicare physician fee schedule. It is aimed at physicians, compliance staff, and medical coders who need to track changes to designated health services, understand which service categories were added or removed, and review whether their referral arrangements and billing practices may be affected. The article also notes a small set of items that fall under Stark exceptions and provides a source reference to the final 2015 Medicare physician fee schedule.
Why This Topic Matters
Stark-related service list changes can affect physician referral arrangements, billing compliance, and internal review processes. Keeping the covered-service list current helps practices identify potential compliance exposure when the Medicare physician fee schedule is updated.
Article Sections
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Compliance
Introduces the topic of Stark Physician Self-Referral compliance and the importance of reviewing service-list revisions in the physician fee schedule.
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Prohibited services
Summarizes designated health service categories with additions and deletions that are relevant to Stark-covered referrals and billing review.
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Stark exceptions
Summarizes a separate set of items discussed in relation to Stark exceptions and identifies categories with no changes in this update.
What You Will Learn
- Which broad designated health service categories were updated in the fee schedule notice
- How the article frames Stark compliance risks for physician practices
- Which service groups are discussed separately as exception-related updates
- What source document the article cites for the update
Who Should Read This
- Physicians
- Practice managers
- Compliance officers
- Medical coders
- Revenue cycle staff
Codes Discussed
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