Can your employee see patients offsite?

Q: I've hired a physical therapist to work part time in my office. He also has his own practice at another location. Some patients have asked if they could have their physical therapy at his office because they find his office hours at our practice inconvenient. Would it violate any laws if we send them there? He would be seeing them as our employee and we would continue to bill their insurance carriers.

A: Yes, the arrangement you describe would violate Stark laws if the patient were covered by Medicare or Medicaid. It might also violate state self-referral regulations. Under Stark, the physical therapist, as your employee, can see your patients only in the building where you practice or at a "centralized" place used by your group and not shared with anyone else.