MASSACHUSETTS - REFERRALS

I. CONSULTING PHYSICIANS FROM ANOTHER STATE

1. May a physician request a consultation from a physician licensed in another state?

A physician may provide consultations to a physician duly authorized to practice medicine in the commonwealth of Massachusetts.

M.G.L.A. 112 § 7

II. SELF-REFERRALS

1. What are the regulations governing the referral of patients by a physician to health care facilities in which the physician has a financial interest?

A. Disclosure.

A physician who refers a patient to any facility which provides physical therapy services and in which the license has an ownership interest must disclose this ownership interest to the Board of Registration in Medicine.

1. This disclosure must include a description of the ownership structure of the facility and the nature of his/her interest in the facility, including the percent of total ownership interest represented by his/her share.

2. This disclosure must also include the names of all other parties who have ownership interests in the facility and the nature and amount of their shares of ownership interests.

B. Notice.

Each patient who is referred by a physician must be furnished by the physician with a written referral which states conspicuously on its face the following: “The referring licensee maintains an ownership interest in the facility to which you are being referred for physical therapy service. Physical therapy services may be available elsewhere in the community.”

C. Ownership interest.

“Ownership interest” means any and all ownership interest including, but not limited to, any membership, proprietary interest, stock interest, partnership interest, co-ownership in any form or any profit-sharing arrangement. Ownership interest does not apply to financial arrangements between a health maintenance organization or a preferred provider arrangement and its participating providers, or to financial arrangements among participating providers of health maintenance organizations or preferred provider arrangements.

243 MA ADC 2.11

Copyright © Kern Augustine Conroy and Schoppmann, P.C. Used with permission.

Updated 2008