c.2006 alice g. gosfield stark and anti-kickback protections for giving ehr and e-prescribing to...
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c.2006 Alice G. Gosfield
Stark and Anti-kickback Protections for Giving EHR and e-Prescribing to Physicians
Website Slides
Alice G. Gosfield
c.2006, Alice G. Gosfield
Who can give
Electronic prescribing: Same Hospital to member of medical staff PDP sponsor or MA organization Group practice to a “member”
EHR: Those plus, an ‘entity’ under Stark; For AKS – any entity which provides services and
submits claims under a federal health care program
c.2006, Alice G. Gosfield
Who can receive
A physician on staff of a hospital as long as eligibility does not take into account volume or value or referrals
Things that are OK to consider: Total # of scripts; size of practice (e.g., # of pts, pt
encounters, or RVUs); total # of hrs physician works; overall use of automated technology in the practice; level of uncompensated care physician renders
Any other reasonable and verifiable judgment not reflective of volume or value of referrals
c.2006, Alice G. Gosfield
What can be given
Electronic prescribing items and services Hardware, software or information
technology, training services “necessary and used solely to receive and transmit electronic prescription info”
Electronic health records Software or IT and training “necessary and
used predominately” for HER – no hardware
c.2006, Alice G. Gosfield
Conditions for Prescribing IT:Written Agreement and More
System meets Part D standardsDonor does not limit or restrict use or compatibility
with other electronic or EHR systemsSystem can be used for any patientReceipt of system is not a condition of referrals by
recipientDonor has no knowledge or does not act in
reckless disregard or deliberate ignorance of whether the physician has equivalent services or items
c.2006, Alice G. Gosfield
Conditions for EHR: Written Agreement and More
Software is interoperable as certified no more than 12 mos before by proper agency
No limitations on uses with other ITBefore receipt, physician pays 15% of donor’s
cost for items or servicesNo donor loans for the paymentRecipient doesn’t condition receipt on referralsNo donor knowledge of physician’s having
equivalent IT
c.2006, Alice G. Gosfield
EHR Conditions (2)
Can be used for all patientsDonation does not include staffing of
physician offices and is not used primarily for personal business or business unrelated to the medical practice
The software contains electronic prescribing capability or the ability to interface with the physician’s electronic prescribing system