Law firm Nexsen Pruet laid out five key Stark Law definitions for group physician practices in a Feb. 15 article in JDSupra.
Here are seven definitions to know:
Single legal entity: The group practice must consist of a single legal entity operating as a physician group practice. This does not include informal physician affiliations formed to share profits from referrals or separate group practices with common ownership.
Physicians: The group practice must have at least two physicians who are members of the group — meaning a direct or indirect owner, a physician employee, a locum tenens physician or an on-call physician.
Range of care: Each physician member must provide the full range of patient care services, including "medical care, consultation, diagnosis and treatment through the joint use of shared office space, facilities, equipment and personnel," the report said.
Services furnished by group practice members: In most cases, patient care services provided by physician members must be billed through the group. Patient care services are measured by the total time each member spends on patient care services fixed in advance of the service performed.
Distribution of expenses and income: The overhead expenses and income must be distributed by methods determined before the payment for the services.
Unified business: The group practice must be a unified business with a centralized decision-making body in control of the assets and a consolidated billing.
Physician-patient encounters: Physician members must personally conduct at least 75 percent of the physician-patient encounters.