Should you display and disclose?
If you do, do you document and file a copy of the disclosure?
If not, you may be subject to a $5,000 fine and a misdemeanor conviction under a provision of the Maryland Patient Referral Law.
Much attention is paid to whether a health care provider may or may not refer a patient to an entity in which the referring provider has a financial interest, but perhaps too little attention is being paid to the disclosure, display and filing requirements that are associated with
certain permitted referrals.
Health care practitioners in Maryland, which includes physicians, dentists, chiropractors and optometrists, who own an interest in a separate health care entity and refer patients to that health care entity, must disclose that ownership relationship to their patients. In all but a few excepted scenarios, the Maryland Patient Referral Law requires that patients review and sign a written notice that discloses the ownership interest, and states that the patient may choose to obtain the referred services from a different health care entity.
Furthermore, the health care practitioner must display a sign that is plainly visible from eight feet away in his or her office that lists all of the entities in which the health care practitioner has an ownership interest. The disclosed ownership interest includes interests by equity or loan, and interests owned by the health care practitioner's spouse, children, parents, siblings and their respective spouses.
Health care providers must file a copy of the disclosure signed by each patient in each patient's medical record. The Maryland Patient Referral Law also requires that practitioners document a valid medical need for the referred service in the patient's medical record.
Certain financial interests, however, are excepted from the disclosure, display and filing requirements. These requirements do not apply to practitioners that refer patients either to other practitioners within their group practice or for in-office ancillary services, such as x-rays or blood tests.
Furthermore, referrals to an entity owned or controlled by a hospital, such as a hospital-owned ambulatory surgical center, are exempt from these requirements. On the other hand, referrals by owners of an ambulatory surgery center, not owned or controlled by a hospital, and not part of the referrer's group practice, are subject to the disclosure and filing requirements.
Health care practitioners that do not disclose, display and file, and do not fall within an exception, are subject to criminal misdemeanor prosecution and up to a $5,000 fine, even if the referral is otherwise permitted under the Maryland Patient Referral Law.
The bottom line is that, if you must disclose, display and file, you should.