decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Group Practice / Group member defined
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Article Overview
This premium article covers the definition of a group practice member under Stark Law and how that definition affects compliance analysis for physician groups. It is intended for coding and compliance professionals who need to understand which categories of individuals are counted as members versus excluded from group practice tests and related practice arrangements. The discussion references federal regulatory sources and related CMS and Federal Register guidance.
Why This Topic Matters
Group practice membership can affect Stark compliance, especially when determining whether a practice meets tests that depend on the activities of group members. Understanding the scope of membership is important for practices using employed physicians, locum tenens physicians, on-call coverage, leased personnel, or independent contractors.
What You Will Learn
- How group practice membership is defined for Stark Law purposes
- Which broad categories of practitioners may be counted as members
- Why membership status matters for group practice compliance analysis
- How the article situates membership issues within related CMS and regulatory guidance
Who Should Read This
- Physician group administrators
- Health care compliance professionals
- Medical coders supporting physician practice compliance
- Health law and reimbursement analysts
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