On June 9, 2022, the Centers for Medicare & Medicaid Services (“CMS”) published a notice seeking public comment on its plan to revise the way information is collected under its voluntary Self-Referral Disclosure Protocol (“SRDP”).
Specifically, the proposed rule would allow a group practice to submit a single “Group Practice Information Form” that would cover all of the physicians in the practice when disclosing noncompliance with the federal physician self-referral law (“Stark Law”). As things currently stand, the disclosing group must complete a separate “Physician Information Form” for each individual physician named in the group’s self-disclosure.
The proposed rule intends to simplify the SRDP process and minimize the “information collection burden” that may otherwise result from the submission and review of multiple forms. Moreover, the proposal will build on CMS’s previous efforts to ease one of the many regulatory burdens faced by providers seeking to participate in the SRDP. The proposed group practice information form requires that the group practice provide a detailed description of the nature of noncompliance, the method of cure or termination of the issue, period(s) of noncompliance, date of discovery and an Excel spreadsheet that includes the following information for each physician in the practice that made prohibited referrals to the practice during the applicable period:
- Physician’s name
- Physician’s NPI
- Whether the physician is an owner, employee or independent contractor of the practice
- Whether the physician received compensation that failed to comply with the volume or value of referrals requirement
- Period during which the physician made prohibited referrals to the practice
CMS will accept comments on the proposed rule through August 8, 2022.
SRDP Submission Process: What Does the SRDP Form Require?
The SRDP has been updated several times since the CMS process was created in 2010, but continues to require the disclosing entity to provide a comprehensive disclosure, legal analysis and supporting materials relating to the non-compliant arrangement(s) and the disclosing entity.
In structuring disclosures, the SRDP relies on the completion and submission of four forms by the disclosing entity:
- The SRDP Disclosure Form;
- The Physician Information Form(s);
- The Financial Analysis Worksheet; and
- A Certification as to the accuracy and truthfulness of the information submitted with the disclosure.
In addition, disclosing parties have the option of submitting a cover letter that includes information that may be relevant to CMS’s evaluation of the disclosure.
Proposed Revision to the SRDP: What Might Change for Group Practices?
The Physician Information Form requires information regarding each physician involved in the noncompliance that gave rise to the disclosure. Since June 1, 2017, disclosing parties using the SRDP are required to complete a separate form for each physician involved.
If, for example, a physician group of 50 members discloses a non-compliant referral arrangement, the group practice would need to fill out 50 Physician Information Forms — one for each physician — in addition to a detailed description of the non-compliant arrangement(s).
The proposed revision, if finalized, would allow a physician practice disclosing noncompliance to submit a single Group Practice Information Form covering all the physicians in the practice who made prohibited referrals to the practice instead of submitting a multitude of individual forms.
Practical Takeaways
The proposal, if finalized, may provide some administrative relief for physician practices submitting disclosures through the SRDP process by reducing the voluminous nature of the submission; however, while the Group Practice Information Form may result in a shorter submission packet, it appears that physician practices will have to provide nearly all of the same information as the current process (but in a more concise format). It is important to note that hospitals and other non-physician practice organizations would still be required to complete individual Physician Information Forms for each physician member of the applicable physician practice subject to the disclosed financial arrangement.
Given the complex nature of the SRDP process and related forms, providers considering self-disclosure are strongly encouraged to seek counsel for appropriate legal analyses and SRDP Form completion strategies.
If you would like assistance navigating the SRDP process, or if you would like assistance submitting a comment to CMS regarding the proposed updates to the physician practice SRDP process prior to the August 8, 2022 deadline, please contact:
- Joe Wolfe at (414) 721-0482 or jwolfe@hallrender.com;
- Scott Taebel at (414) 721-0445 or staebel@hallrender.com;
- Keith Dugger at (214) 615-2051 or kdugger@hallrender.com;
- Alyssa James at (317) 429-3640 or ajames@hallrender.com; or
- Your primary Hall Render contact.
Special thanks to Summer Associate, Avi Kerendian, for assisting with this article.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot give legal advice outside of an attorney-client relationship.
