Federal restrictions on physician self-referral prevent doctors from prescribing “designated health services” (DHS) that are payable by Medicare or Medicaid to an entity with which the physician has a financial relationship. Each state also has a variation of these regulations, which may or may not emulate federal law.
The staffing and credentialing process is critical, particularly because many health care practitioners rely on staff privileges and hospital credentialing to increase their patient pool through referrals. Rejections from hospitals and third-party payers can devastate a health care business and cause irreparable damage to a business’s reputation.
As a medical doctor, state and federal regulations may apply to advertisements of your services. It is important that you and your marketing crew understand the limits placed on physician marketing and advertising by regulation.
HIPAA requires particular privacy standards when “covered entities” and “business associates” handle private health information (PHI). It also provides administrative, physical, and technical security requirements, notification requirements in the event of a data breach, and standardized practices for processing health care claims.
