If a hospital pays for a service that benefits a member
of its medical staff, the government considers it a form of
remuneration under the Stark law. It is not clear, however,
whether this service is properly classified as a benefit
to the members of the medical staff.
Arguably, the chart abstraction service is more properly
viewed as a benefit to the hospital, because it results in
a more timely and accurate hospital medical record. That
the service also saves time for physicians should not
matter. Similar savings might be achieved if a hospital
implemented a computerized physician ordering system.
Yet, in that case, no one would suggest that this technical
innovation is a form of remuneration to medical the
staff.
There are services a hospital could provide to its medical
staff that would clearly benefit the physicians; these
constitute remuneration for Stark purposes. For example,
if your hospital offered chart abstraction or other professional
services that members of the medical staff used
exclusively in their private office practices, this service
would likely qualify as remuneration. However, Stark
has two exceptions that might trump this: One allows
nonmonetary compensation up to $300, and the other
approves compliance training for medical staff.
Your best bet: Consider whether you could structure the
chart abstraction service to fit within the new regulatory
exception for “medical staff incidental benefits.” See 42
CFR § 411.357(m) for details.
