On January 31, 2008 CMS posted on its website a number of Frequently Asked Questions (FAQs) that clarify the following concerns raised after CMS published the Stark Phase III final rule on September 5, 2007 (effective December 4, 2007):
- "physician organization" means a physician practice comprised of two or more physicians, but not hospitals, federally qualified health centers, or single legal entities that operate both a faculty practice plan and a medical school, hospital, or both;
- provisions for termination of office and equipment leases also apply to personal services agreements;
- under the "stand in shoes" rule for physicians and their physician organizations, individual physicians need not sign agreements; rather, the physician organizations may sign agreements;
- physician ownership is not required for physician organizations or physician practices;
- the physician recruitment exception is available to recruit residents trained at the recruiting hospital in some circumstances;
- the" stand in shoes" "grandfathering rule" applies only to arrangements that met both the definition of "indirect compensation arrangement" and the requirements of the "indirect compensation exception" as of September 5, 2007; and
- in order to be a "physician in the group practice" a physician providing independent contractor physician services (even if employed by a group practice) to another group practice must either i) sign the agreement directly with the other group practice, or ii) sign an agreement between the two group practices, which must identify the physician by name.