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May 04, 2012

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It is my understanding that the rules for Shared Savings and Accountable Care Organizations only apply to hospitals and healthcare providers. But if a hospital and healthcare provider want to contract with an HMO or vice versa, then they can do so. Stark applies to self referal for physician offices and has been the primary driver for hospitals to buy up physician practices. I can't self refer my imaging under stark, hospitals can't insentivise physicians for referals to hospitals but if the practice is owned by the hospital, then referals can happen all day long.

Are there any rules or guidelines under which hospitals that are capitated for outpatient or inpatient services to COMMERCIAL HMOs can establish shared savings programs with physicians on the hospital's medical staff and be exempt from enforcement actions under Stark and other related regulations?

Thanks for your kind informtion and sharing with us….

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