Thomas Clarifies Self-Referral Law Washington Rep. Bill Thomas, R-Calif., has introduced legislation to clarify the physician self-referral law. Although passed six years ago as "Stark II," the law was designed to bar a doctor from referring Medicare patients to 11 health services-including durable medical equipment-where he or she may benefit financially. But the Health Care Financing Administration still has not issued final regulations.

Thomas' bill would still bar doctors from making referrals to entities they own but would allow compensation to doctors for referrals to facilities they do not own.

Thomas, along with Rep. Pete Stark, D-Calif., also introduced the Medicare Appeals Act of 1999, which the Health Industry Manufacturers Association has lobbied to get on the legislative fast track.

The bill would enhance the rights of Medicare patients in appealing decisions made by HCFA and local contractors to not pay for new technology. Pam Baily, HIMA president, said that it is "unconscionable" how bureaucracy hinders Medicare from providing new technology to patients.

"This bill will address these problems by making the appeals process clearer, more effective and timely," she said. "The result: Medicare will provide patients more timely access to needed medical technologies."

Final Rule Published On Penalties Washington The Office of Inspector General published a final rule on civil monetary penalties for providers who commit health care fraud.

The penalty for violating the anti-kickback statute is up to $50,000 per violation. The penalty for knowingly employing or entering into contracts for medical services with excluded individuals is up to $10,000 per violation.

The OIG will also have expanded power to exclude providers from federal programs; to permanently exclude individuals convicted of three or more health care-related crimes; to exclude for 10 years individuals convicted of two health care-related crimes; and to exclude entities controlled by family members of sanctioned individuals.

The final rule was mandated by the Balanced Budget Act of 1997.

NAMES Cites Flaws in Evaluation Washington The National Association for Medical Equipment Services has raised concerns about the Peer Review Evaluation of Home Oxygen Equipment, a study mandated by the Balanced Budget Act of 1997 that measures the effect of Medicare oxygen reimbursement cuts the last two years.

Designed for providers, physicians and patients, the survey will take too long to complete and result in reduced response rate and answer accuracy, according to Asela Cuervo, assistant vice president of regulatory affairs for NAMES.

NAMES also expressed concern about plans for using secondary data, including Medicare claims and certificates of medical necessity for home oxygen services for 1996 and 1998, to gather evidence about the impact of the fee schedule reductions without including data from the 1999 cut. -K.G.