Page:United States Statutes at Large Volume 103 Part 3.djvu/173

 PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2241 which the physician routinely provides (including medical care, consultation, diagnosis, or treatment) through the joint use of shared office space, facilities, equipment, and personnel; '' "(B) for which substantially all of the services of the physicians who are member? of the group are provided through the group and are billed in the name of the group and amounts so received are treated as receipts of the group; "(C) in which the overhead expenses of and the income from the practice are distributed in accordance with meth- ods previously determined by members of the group; and "(D) which meets such other standards as the Secretary may impose by regulation. In the case of a faculty practice plan associated with a hospital, with an approved medical residency training program in which physician members may provide a variety of different specialty services and provide professional services both within and out- side the group (as well as perform other tasks such as research), the previous sentence shall be applied only with respect to the services provided within the faculty practice plan. "(5) INTERESTED INVESTOR; DISINTERESTED INVESTOR. —The term 'interested investor' means, with respect to an entity, an inves- tor who is a physician in a position to make or to influence referrals or business to the entity (or who is an immediate family member of such an investor), and the term 'disinterested investor' means an investor other than an interested investor. " (6) REFERRAL; REFERRING PHYSICIAN.— "(A) PHYSICIANS' SERVICES. —Except as provided in subparagraph (C), in the case of a clinical laboratory service which under law is required to be provided by (or under the supervision of) a physicigm, the request by a physician for the service, including the request by a physician for a consultetion with another physician (and any test or proce- dure ordered by, or to be performed by (or under the ^* '" " supervision of) that other physician), constitutes a'referral' by a 'referring physician'. "(B) OTHER ITEMS. —Except as provided in subparagraph (C), in the case of another clinical laboratory service, the request or establishment of a plan of care by a physician which includes the provision of the clinical laboratory serv- ice constitutes a 'referral' by a 'referring physician'. " (C) CLARIFICATION RESPECTING CERTAIN SERVICES INTEGRAL TO A CONSULTATION BY CERTAIN SPECIAUSTS. — A request by a pathologist for clinical diagnostic laboratory tests and pathological examination services, if such services are furnished by (or under the supervision of) such patholo- gist pursuant to a consultetion requested by another physician does not constitute a 'referral' by a 'referring physician'. ", (b) REQUIRING REQUESTS FOR PAYMENT TO INCLUDE INFORMATION ON REFERRING PHYSICIAN. — Section 1833 of such Act (42 U.S.C. 13951) is amended by adding at the end the following new subsection: "(q)(1) Each request for payment, or bill submitted, for an item or service furnished by an entity for which payment may be made under this part and for which the entity knows or has reason to believe there has been a referral by a referring physician (within the

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