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...(Part 1)," FPM, March 2008.) This article addresses issues tied to the relationships between physicians and the hospitals at which they attend and to which they refer.
Recruitment
The Stark statute protects hospitals that assist physicians relocating to the community with practice support, including an income guarantee. The "Stark II, Phase II" regulations published in 2004 made it clear that the hospital cannot require the recruited physician to refer patients to the facility.
Typically in these situations, a hospital provides the recruit with an income guarantee loan for a year while the recruited physician establishes a practice in the community. After a year's worth of support, the hospital forgives a portion of that loan for each month the physician stays in the community, so eventually no repayment is necessary. But if the physician leaves the community, the loan becomes immediately due.
In Phase II, the hospital was explicitly permitted to provide support to group practices that refer to the hospital when they recruited a physician to join them. In addition to providing the income guarantee, the hospital could pay for the costs of adding the physician to the practice. The addition of phone lines, furniture, cell phones, pagers, additional support staff dedicated to the new physician...
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