CMS Issues Advisory Opinion on Stark Rural Provider Exception
CMS issued an advisory opinion concluding, based on the facts certified, that physician owners of a diagnostic center located in a micropolitan statistical area may refer patients to the center for designated health services (DHS) without violating the Federal physician self-referral (Stark) regulations because the arrangement would satisfy the "rural provider" exception. The rural provider exception, which applies only to ownership or investment interests in DHS entities, requires that (a) the DHS is furnished in a rural area; and (b) substantially all of the DHS furnished by the entity (not less than 75%) must be furnished to residents of a rural area. "Rural area" means an area that is not an urban area. "Urban area" is defined at 42 C.F.R. 412.62(f)(1)(ii) to include Metropolitan Statistical Areas and New England County Metropolitan Areas (as defined by the Office of Management Budget) or certain specified New England counties.
