(a) This subpart implements section 1877 of the Act, which generally prohibits a physician from making a referral under Medicare for designated health services to an entity with which the physician or a member of the physician's immediate family has a financial relationship.
(b) This subpart does not provide for exceptions or immunity from civil or criminal prosecution or other sanctions applicable under any State laws or under Federal law other than section 1877 of the Act. For example, although a particular arrangement involving a physician's financial relationship with an entity may not prohibit the physician from making referrals to the entity under this subpart, the arrangement may nevertheless violate another provision of the Act or other laws administered by HHS, the Federal Trade Commission, the Securities and Exchange Commission, the Internal Revenue Service, or any other Federal or State agency.
(c) This subpart requires, with some exceptions, that certain entities furnishing covered services under Medicare report information concerning ownership, investment, or compensation arrangements in the form, in the manner, and at the times specified by CMS.
(d) This subpart does not alter an individual's or entity's obligations under—
(1) The rules regarding reassignment of claims (§ 424.80 of this chapter);
(2) The rules regarding purchased diagnostic tests (§ 414.50 of this chapter);
(3) The rules regarding payment for services and supplies incident to a physician's professional services (§ 410.26 of this chapter); or
(4) Any other applicable Medicare laws, rules, or regulations.
[85 FR 77656, Dec. 2, 2020]
Notes of Decisions
Fresenius Med. Care Holdings, Inc. v. Tucker, 704 F.3d 935 (11th Cir. 2013).
· cites it 4× “” 42 C.F.R. § 411.350 (b). The district court also reasoned that the regulation of medical fees was and is a typical exercise of state police power, and that the Florida Legislature was not alone in imposing physician self-referral restrictions that are more restrictive than…”
Fresenius Med. Care Holdings, Inc. v. Francois, 832 F. Supp. 2d 1364 (N.D. Fla. 2011).
“” 42 C.F.R. 411.350(b). The regulations explain that “although a particular arrangement involving a physician’s financial relationship with an entity may not prohibit the physician from making referrals to the entity under this sub-part, the arrangement may nevertheless violate .”
Fresnius Med. Care Holdings, Inc. v. Elisabeth Tucker, M.D. (11th Cir. 2013).
· cites it 3× “” 42 C.F.R. § 411.350 (b). The district court also reasoned that the regulation of medical fees was and is a typical exercise of state police power, and that the Florida Legislature was not alone in imposing physician self-referral restrictions that are more restrictive than…”
Fresnius Med. Care Holdings, Inc. v. Elisabeth Tucker, M.D. (11th Cir. 2013).
· cites it 3× “” 42 C.F.R. § 411.350 (b). The district court also reasoned that the regulation of medical fees was and is a typical exercise of state police power, and that the Florida Legislature was not alone in imposing physician self-referral restrictions that are more restrictive than…”
Byrd v. Acadia Healthcare Co., Inc. (M.D. La. 2022).
“, which provide that, if a physician has a “financial relationship” with an entity (that is, an ownership or investment interest or a “compensation arrangement”), then that physician generally cannot make a referral to the entity for the furnishing of “designated health…”
— 42 C.F.R. § 411.350(b) — 1 case
Fresenius Med. Care Holdings, Inc. v. Francois, 832 F. Supp. 2d 1364 (N.D. Fla. 2011).
“” 42 C.F.R. 411.350(b). The regulations explain that “although a particular arrangement involving a physician’s financial relationship with an entity may not prohibit the physician from making referrals to the entity under this sub-part, the arrangement may nevertheless violate .”
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