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 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.
Physician-owned Hospital (POH) Initial Annual Ownership/Investment Report: Extension of Filing Deadline
CMS has closely examined the data collected in the Initial Annual Ownership/Investment Report required of physician-owned hospitals seeking to avail themselves of the hospital ownership or rural provider exceptions. We are concerned about the accuracy of these data. Accordingly, we are extending the deadline for the POH Initial Annual Ownership/Investment Report, and will provide additional information, when available, regarding the revised deadline.
Hospitals that did not file the required information by the earlier deadline of March 3, 2014 may have refrained from filing claims after that date to avoid violating the physician self-referral law’s claim submission prohibition. Because of the deadline extension, submission of those claims may be permissible. Please refer to 42 CFR §424.44 for timely filing guidelines regarding such claims. Please stay tuned to our website as well as the normal CMS communication channels for notifications related to this issue.
The CY 2015 OPPS/ASC final rule with comment period was published on November 10, 2014. Changes to the Rural Provider and Hospital Ownership Exceptions to the Physician Self-Referral Law: Expansion Exception Process can be found at:
Lake Pointe Medical Center (Rowlett, TX) submitted the following exception request: http://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Downloads/LakePointe.pdf. The corresponding decision notice has been published in the Federal Register and may be found at: http://www.gpo.gov/fdsys/pkg/FR-2014-10-31/pdf/2014-25940.pdf.
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- Page last Modified: 02/25/2015 5:40 PM
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