Spotlight

The Physician Self-Referral Spotlight page highlights recently updated information.

Self-Referral Disclosure Protocol FAQs
Frequently Asked Questions related to the CMS Voluntary Self-Referral Disclosure Protocol can be found in the FAQs database. Just select "Fraud and Abuse - Physician Self Referral" in the left-hand menu to view the questions. A document containing all SRDP FAQs is also available to download at: http://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Downloads/FAQsPhySelfRef.pdf. (Posted May 23, 2012)

§ 411.362 (c) – Instructions for Submitting a Request for an Exception to the Prohibition on Facility Expansion
We have published more detailed information associated with the exception process for Physician-Owned Hospitals. As stated in the November 30, 2011 OPPS Final Rule, in order to receive an exception to the prohibition on facility expansion, a hospital must satisfy eligibility criteria to qualify as an "Applicable Hospital" or "High Medicaid Facility." This additional guidance will address the process for accessing data and provide sample computations for determining whether a hospital satisfies the respective criteria. (Posted January 31, 2012)

Designated Health Services
The most recent update of the DHS list was effective on 1/1/2013 and can be found at:
List of codes effective January 1, 2013, published November 16, 2012 (77 FR 69334) [ZIP, 54KB] .  (Posted January 31, 2012)

Self-Referral Disclosure Protocol – Report to the Congress
On March 23, 2012, CMS delivered a report to the Congress on the implementation of the Medicare Self-Referral Disclosure Protocol. The report can be found at: Physician Self-Referral Disclosure Protocol Report to Congress. (Posted March 30, 2012)

Self-Referral Disclosure Protocol Settlements
The CMS Voluntary Self-Referral Disclosure Protocol (SRDP) enables providers of services and suppliers to self-disclose actual or potential violations of the physician self-referral statute. (Posted March 29, 2012)

Recent Settlements:

• 3/9/2012 - CMS settled violations of the physician self-referral statute disclosed by a physician group practice located in Iowa under the SRDP. [view details]
• 3/20/2012 - CMS settled a violation of the physician self-referral statute disclosed by an acute care hospital located in Arizona under the SRDP. [view details]
• 4/5/2012 – CMS settled a violation of the physician self-referral statute disclosed by a hospital located in North Carolina under the SRDP. [view details]