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June 21, 2024

Physician Self-Referral Exception for Physician Wellness Programs

By Bob Wade

American Health Law Association

Addressing the prevalence of substance abuse amongst medical professionals has become a focal point over the last few years. When the Consolidated Appropriations Act (CAA) was signed into law in 2022, it included a new exception allowing healthcare entities to provide physicians and other clinicians access to mental and behavioral health programs. In an article published by the American Health Law Association on June 19, Nelson Mullins partner Bob Wade breaks down the nuts and bolts of the new exception and what it means for healthcare entities and physicians struggling with alcohol or drug addiction.

In an excerpt, Wade offers insight for those seeking to implement physician wellness programs:  

The new physician wellness program exception will allow healthcare entities to offer mental and behavioral health support programs without the threat of violating the Stark Law or the Anti-Kickback Statute. The aim of the CAA is to help improve the mental health of healthcare providers and ultimately reduce healthcare costs and benefit patient outcomes. Entities that seek to implement such a program should carefully evaluate each requirement of the exception to ensure compliance.

Bob is an experienced healthcare attorney and counsels clients on fraud and abuse issues, fair market value, commercial reasonableness and developing, monitoring, and documenting effective healthcare compliance programs. He serves clients nationally as a compliance professional and assists in negotiating and implementing corporate integrity agreements and in documenting and defending financial arrangements being of fair market value and commercially reasonable between healthcare providers.

Subscribers can access the full article here.