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Another perspective on Stark II

A guest blog from Kevin Bunnell, EdD, a CME consultant based in Boulder, Colo., and former Alliance for CME president, commenting on the opinions of attorney Jim Miles, of Miles & Peters, PC, on Stark II thatI posted recently (click here to read the original post):

    A word on the $300 limit on emoluments to physicians that are exempted under Stark II. All benefits such as free meals, free parking, free golf, and so on must have their value imputed, recorded, and counted toward the $300 exemption. The CMS "enforcers" have said informally that an imputed value to a physician for a single CME activity would be $25. Hence, a CME office can offer twelve CME activities a year for medicare referring physicians--assuming they get no other emoluments that would also have to be counted toward the exemption.

    I have not heard before of the idea that the total value of a CME activity to physicians is equal to the honorarium paid to the speaker. And I have not heard of imputing the value of the activity to individual physicians by dividing the amount of the honorarium by the number of physicians attending

    the activity.

    And as if this mess weren't bad enough, think of the record keeping involved in keeping track of all of the emoluments received by all the referring physicians associated with a hospital.

    As the CEO of a large hospital or a hospital system, I would be reluctant to take Mr. Miles' optimistic position until the word came directly from CMS saying that they really didn't mean that we should not help physicians to improve the way they take care of medicare patients. The fines so far have been horrendous.

Sue again: I was unable to get in touch before my deadline ran out with many of the various different organizations--AMA, AHA, CMSS etc.--that undoubtedly will be bringing pressure to bear on CMS to take CME out of the Stark II loop. If anyone knows what they're planning to do on this one, please let me know. We'll be following up on this one in future issues, I'm sure.

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