On September 13, 2013, the Centers for Medicare & Medicaid Services (“CMS”) issued a Medical Learning Network Letter (“Letter”) addressing new guidance for meeting the annual reporting requirements for physician-owned hospitals.1 The Letter affects hospitals with physician ownership and/or investors wishing to rely on the whole hospital or rural provider exception to the Stark Law and requires such facilities seeking to utilize the whole hospital or rural provider exception to meet the annual reporting requirement no later than December 1, 2013.
Background
Section 6001 of the Affordable Care Act imposed additional reporting requirements on physician-owned hospitals availing themselves of the whole hospital or rural provider exception. 42 CFR 411.362(b)(3)(i) provides: “At such time and in such manner as specified by CMS, the [physician-owned] hospital must submit an annual report to CMS containing a detailed description of the identity of each owner or investor in the hospital and the nature and extent of all ownership and investment interests in the hospital.” Until recently, CMS had remained silent in regard to the implementation of these reporting requirements.
New Guidance
However, the Letter explains that physician-owned hospitals must complete the Medicare Enrollment Application Form CMS-855A no later than December 1, 2013. In addition, the Letter explains that physician-owned hospitals will be required to either update or verify their information in the Medicare Provider Enrollment, Chain and Ownership System on an annual basis. Physician-owned hospitals that submitted a CMS-855A on or after December 1, 2012 will be considered to have met the December 1, 2013 deadline.
CMS-855A requires every physician-owned hospital to report every organization that has any percentage of ownership or investment interest in the physician-owned hospital, as well as every individual that has any percentage of ownership or investment interest in the hospital. This reporting requirement will be an annual obligation for physician-owned hospitals. Information submitted to CMS via this process may be published on the CMS website.
If you have any questions or would like additional information on this topic, please contact Andrea Impicciche at 317.977.1578 or aimpicciche@hallrender.com or your regular Hall Render attorney.
Special thanks to Alyssa James, Law Clerk, for her assistance with the preparation of this Health Law News article.
1 MLN Matters, SE 1332, September 13, 2013
