Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to qualify for the whole hospital and rural provider exceptions. A physician-owned hospital is now generally prohibited from expanding facility capacity. However, a physician-owned hospital that qualifies as an applicable hospital or high Medicaid facility may request an exception to the prohibition from the Secretary.
For further information about the process and its requirements, see the links below. After reviewing the material below, if you have additional questions, please call the CMS Physician Self-Referral Call Center at (410)786-4568 or send an email to POHInquiries@cms.hhs.gov. Requests for exceptions should not be sent to this address, but may be emailed to the address below.
Hospitals requesting an exception in accordance with the statutory requirements may submit an exception request either electronically to POH-ExceptionRequests@cms.hhs.gov or by mailing an original and one copy of its request to:
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Mailstop C4-25-02, ATTN: Physician-Owned Hospital Exceptions
Baltimore, MD 21244-1850
If a hospital submits its request electronically, the hospital must also submit an original hard copy of the required certification.
Important Update: Lake Pointe Medical Center (Rowlett, TX) has submitted the following exception request http://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Downloads/LakePointe.pdf
Additional Reporting Requirements Concerning Physician Ownership and Investment in Hospitals
Important Update: The deadline for physician-owned hospitals to report ownership and investment information pursuant to Section 6001 of the Affordable Care Act has been extended to March 1, 2014. Physician-owned hospitals that submitted the information on or after December 1, 2012, consistent with the process specified in MLN Matters Number SE1332, will be considered to have met the new March 1, 2014 deadline. An update of MLN Matters Number SE1332 can be found at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE1332.pdf.
On 9/13/2013, CMS issued an MLN Matters® Special Edition Article to address the additional reporting requirements imposed by Section 6001 of the Affordable Care Act on physician-owned hospitals seeking to available themselves of the whole hospital or rural provider exception to the physician self-referral law. The article can be found at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1332.pdf
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