Spotlight

Waivers of Sanctions under the Physician Self-Referral Law

Blanket Waivers

On March 30, 2020, CMS issued blanket waivers of sanctions under the physician self-referral law for COVID-19 Purposes.  These blanket waivers provide vital flexibility for physicians and providers in the fight against COVID-19.  The waivers are effective March 1, 2020 and may be used without notifying CMS.  View the Blanket Waivers of Section 1877(g) (PDF)

On April 21, 2020, CMS issued explanatory guidance related to the scope and application of the blanket waivers to certain financial relationships. View the Explanatory Guidance (PDF).

UPDATE: On January 30, 2023, the Biden Administration announced its intent to end the national emergency and public health emergency (PHE) declarations on May 11, 2023, related to the COVID-19 pandemic.

When the PHE ends, the Blanket Waivers of Section 1877(g) will terminate in accordance with section II.A., and parties must immediately comply with all provisions of the physician self-referral law.  Parties may not use the blanket waivers after the PHE ends.  Parties are encouraged to act now to ensure arrangements are compliant with the physician self-referral law on or before the end of the PHE.

Individual Waivers

Individual waivers of sanctions under section 1877(g) of the Act may be granted upon request.  Please send your request via email to 1877CallCenter@cms.hhs.gov and include the words “Request for 1877(g) Waiver” in the subject line. All requests should include the following minimum information:

  • Name and address of requesting entity;
  • Name, phone number and email address of person designated to represent the entity;
  • CMS Certification Number (CCN) or Taxpayer Identification Number (TIN) of the requesting entity; and
  • Nature of request.

Unless and until a waiver of sanctions under the physician self-referral law (that is, a waiver of section 1877(g) of the Social Security Act (the Act)) is granted to the requesting party(ies), such party(ies) must comply with section 1877 of the Act and the regulations at 42 C.F.R. § 411.350 et seq.

CMS Voluntary Self-Referral Disclosure Protocol (SRDP) Update

On December 28, 2022, the Office of Management and Budget approved revisions to the SRDP Disclosure Form and related forms that providers of services and suppliers must use in order to utilize the SRDP. The updated forms can be found on the Self-Referral Disclosure Protocol page. Providers of services and suppliers must use the updated forms for disclosures submitted on or after March 1, 2023. 

New Statutory Exception for Physician Wellness Programs

Section 4126 of the Consolidated Appropriations Act, 2023 (CAA 2023) amended section 1877(e) of the Social Security Act (the Act) to establish a new exception to the physician self-referral law for physician wellness programs. Provided that all the requirements of section 1877(e)(9) of the Act are satisfied, a hospital, ambulatory surgical center, community health center, rural emergency hospital, or skilled nursing facility may offer a bona fide mental health or behavioral health improvement or maintenance program to physicians who practice in the geographic area served by such entity. The exception applies to physician wellness programs offered on or after December 29, 2022 (the date of enactment of the CAA 2023).

CPI-U Update

The compensation limits for the nonmonetary compensation, medical staff incidental benefits, and limited remuneration to a physician exceptions have been updated for calendar year 2023 and are now available on the CPI-U Updates page.

List of CPT/HCPCS Codes

The 2023 Code List is now available on the List of CPT/HCPCS Codes webpage.

Final Rule: Modernizing and Clarifying the Physician Self-Referral Regulations

On November 20, 2020, CMS issued a final rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law.  

To view the press release, please visit:  https://www.cms.gov/newsroom/press-releases/cms-announces-historic-changes-physician-self-referral-regulations   

To view the fact sheet, please visit:  https://www.cms.gov/newsroom/fact-sheets/modernizing-and-clarifying-physician-self-referral-regulations-final-rule-cms-1720-f  

 

 

Page Last Modified:
03/02/2023 08:56 AM