42 C.F.R. 411.351 - Definitions

Cite as42 C.F.R. 411.351
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171 practice notes
  • Securing Updated and Necessary Statutory Evaluations Timely
    • United States
    • Centers For Medicare And Medicaid Services,Public Health Service,The Inspector General Office
    • Invalid date
    ...or rescinding each affected regulation individually. To take one example, in 2008 the Department revised the definition of ``entity'' at 42 CFR 411.351. See 73 FR 48434, 48751 (Aug. 19, 2008). The revised definition had the effect of changing the meaning of ``entity'' each time it was used ......
  • U.S. Ex Rel v. Ashcroft, Civil Action No. 3:04–57.
    • United States
    • United States District Courts. 3th Circuit. United States District Courts. 3th Circuit. Western District of Pennsylvania
    • August 21, 2014
    ...of, or the certifying or recertifying of the need for, any designated health service for which payment may be made under Medicare.” 42 C.F.R. § 411.351. The Stark Act defines prohibited financial relationships to include any compensation paid directly or indirectly to a referring physician.......
  • U.S. Ex Rel v. Ashcroft, CIVIL ACTION NO. 3:04-57
    • United States
    • United States District Courts. 3th Circuit. United States District Courts. 3th Circuit. Western District of Pennsylvania
    • August 21, 2014
    ...of, or the certifying or recertifying of the need for, any designated health service for which payment may be made under Medicare." 42 C.F.R. § 411.351. The Stark Act defines prohibited financial relationships to include any compensation paid directly or indirectly to a referring physician.......
  • United States v. Citizens Med. Ctr., Civil Action No. 6:10–CV–64.
    • United States
    • United States District Courts. 5th Circuit. United States District Courts. 5th Circuit. Southern District of Texas
    • September 20, 2013
    ...argument that the 28 individual referrals alleged are exempt under Stark's personal services exception, see42 U.S.C. § 1395nn(h)(5); 42 C.F.R. § 411.351 (exception from liability for referrals for which the services rendered were personally performed by the same physician who made the refer......
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62 cases
  • U.S. Ex Rel v. Ashcroft, Civil Action No. 3:04–57.
    • United States
    • United States District Courts. 3th Circuit. United States District Courts. 3th Circuit. Western District of Pennsylvania
    • August 21, 2014
    ...of, or the certifying or recertifying of the need for, any designated health service for which payment may be made under Medicare.” 42 C.F.R. § 411.351. The Stark Act defines prohibited financial relationships to include any compensation paid directly or indirectly to a referring physician.......
  • U.S. Ex Rel v. Ashcroft, CIVIL ACTION NO. 3:04-57
    • United States
    • United States District Courts. 3th Circuit. United States District Courts. 3th Circuit. Western District of Pennsylvania
    • August 21, 2014
    ...of, or the certifying or recertifying of the need for, any designated health service for which payment may be made under Medicare." 42 C.F.R. § 411.351. The Stark Act defines prohibited financial relationships to include any compensation paid directly or indirectly to a referring physician.......
  • United States v. Citizens Med. Ctr., Civil Action No. 6:10–CV–64.
    • United States
    • United States District Courts. 5th Circuit. United States District Courts. 5th Circuit. Southern District of Texas
    • September 20, 2013
    ...argument that the 28 individual referrals alleged are exempt under Stark's personal services exception, see42 U.S.C. § 1395nn(h)(5); 42 C.F.R. § 411.351 (exception from liability for referrals for which the services rendered were personally performed by the same physician who made the refer......
  • Council for Urological Interests v. Burwell, No. 13–5235.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (District of Columbia)
    • June 12, 2015
    ...with ownership interests in groups that perform outpatient services in hospitals cannot refer patients for the procedures. See 42 C.F.R. § 411.351. With respect to the equipment rental exception, the rule states that the lease may not use per-click rates. 42 C.F.R. § 411.357(b)(4)(ii)(B). T......
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79 firm's commentaries
  • CMS and the OIG Issue Final Rules Modernizing and Clarifying the Federal Stark and Anti-Kickback Laws
    • United States
    • JD Supra United States
    • December 22, 2020
    ...than a pharmacy or a physician, provider, or other entity that primarily furnishes services). Value-Based Enterprise ParticipantCMS (42 CFR § 411.351)OIG (42 CFR § 1001.952(ee)(14)(ix))VBE participant means a person or entity that engages in at least one value-based activity as part of a va......
  • Stark Case Text – Apologies for the Missing Link
    • United States
    • LexBlog United States
    • February 4, 2009
    ...a position to generate business for the other party, on the date of acquisition of the asset or at the time of the service agreement. 42 C.F.R. § 411.351 (emphasis added). As we have explained, BMAA and HMA are in a position to generate business for each other. HMA makes no plausible argume......
  • Murky Waters – The Stark Controversy in Hospital-Physician Relationships
    • United States
    • JD Supra United States
    • November 23, 2020
    ...may be found in the regulations at 42 C.F.R. Part 411. [7] 42 C.F.R. § 411.357(c)(2)(ii). [8] 42 C.F.R. § 411.357(c)(4). [9] 42 C.F.R. § 411.351 (See “Referral” definition – (1)(i)). [10] Press Release, DOJ (Mar. 11, 2014) (https://www.justice.gov/opa/pr/florida-hospital-system-agrees-pay-g......
  • Critical Analysis and Practical Implications of CMS’ Changes to the Stark Law’s Implementing Regulations
    • United States
    • JD Supra United States
    • December 14, 2020
    ...of the Final Rule is ordered consistent with the Final Rule’s order of codification in the Code of Federal Regulations, i.e., from 42 C.F.R. § 411.351 through § 411.357, and is not in any order of importance, except that our discussion of the new exception for “value-based arrangements” (co......
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1 books & journal articles

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