Medicare rules [PDF] that take effect June 8, 2009 require Medicare physicians to tell their patients - in writing at the time of referral - if they or their immediate family members have an ownership or investment interest in the hospital to which they are referring them for treatment. They will lose their medical staff membership and admitting privileges if they don't. The rules also require physician-owned hospitals to tell patients the names of owner physicians who make referrals to the hospital and their immediate owner/investor family members.
"CMS [Centers for Medicare & Medicaid Services] believes that providing patients with early notification of the physician's (or his or her immediate family member's) ownership in the hospital is beneficial to the patient's decision-making concerning his or her treatment," said CMS spokesperson Ellen Griffith. "Thus, requiring physicians to notify patients of the ownership at the time of referral will afford patients the opportunity to discuss the ownership or investment interest in the hospital and make a more informed decision."
She said CMS told Congress in August "that we would promote transparency of investment through disclosing physician ownership to patients."
CMS defines a physician-owned hospital as any Medicare hospital in which a physician or physicians have an ownership or investment interest. The ownership or investment interest may be through equity, debt, or other means and includes an interest in an entity that holds an ownership or investment interest in the hospital.
TMA promotes responsible ownership of all health care facilities, whether owned by a physician, hospital, or other provider. The association believes physicians should fully disclose any interest in a facility to which they refer patients. TMA's policy states that physician-owned entities should adhere to all state and federal regulations; provide appropriate credentialing of physicians and clinical and support staff; perform systematic, ongoing monitoring of utilization and quality; and adhere to relevant TMA and AMA ethical guidelines, including adhering to responsible ownership policy.
Action , April 1, 2009