334.253. Physicians prohibited referral to certain physical therapists, when, financial relationship, defined--exceptions, effective when.
Physicians prohibited referral to certain physical therapists, when,financial relationship, defined--exceptions, effective when.
334.253. 1. A physician may not make a referral to anentity for the furnishing of any physical therapy services withwhom the physician, physician's employer, or immediate familymember of such referring physician has a financial relationship.A financial relationship exists if the referring physician, thereferring physician's employer, or immediate family member:
(1) Has a direct or indirect ownership or investmentinterest in the entity whether through equity, debt, or othermeans; or
(2) Receives remuneration from a compensation arrangementfrom the entity for the referral.
2. The following financial arrangements shall be exemptfrom disciplinary action under this section:
(1) When the entity with whom the referring physician hasan ownership or investment interest is the sole provider of thephysical therapy service within a rural area;
(2) When the referring physician owns registered securitiesissued by a publicly held corporation or publicly traded limitedpartnership, the shares of which are traded on a nationalexchange or the over-the-counter market, provided that suchreferring physician's interest in the publicly held corporationor publicly traded limited partnership is less than five percentand the referring physician does not receive any compensationfrom such publicly held corporation or publicly traded limitedpartnership other than as any other owner of the shares of suchpublicly held corporation or publicly traded limited partnership;
(3) When the referring physician has an interest in realproperty resulting in a landlord-tenant relationship between thephysician and the entity in which the equity interest is held,unless the rent is determined, in whole or in part, by thebusiness volume or profitability of the tenant or is otherwiseunrelated to fair market value;
(4) When the indirect ownership in the entity is by meansof a bona fide debt incurred in the purchase or acquisition ofthe entity for a price which does not in any manner reflect thepotential source of referrals from the physician with theindirect interest in the entity and the terms of the debt arefair market value, and neither the amount or the terms of thedebt in any manner, directly or indirectly, constitutes a form ofcompensating such physician for the source of his business;
(5) When such physician's employer is a health maintenanceorganization as defined in subdivision (6) of section 376.960,RSMo, and such health maintenance organization owns or controlsother organizations which furnish physical therapy services solong as the referral is to such owned or controlled organizationand the physician does not also have a direct or indirectownership or investment interest in such organization, physicaltherapy services or the health maintenance organization and thereferring physician does not receive any remuneration as theresult of the referral;
(6) When such physician's employer is a hospital defined insection 197.020, RSMo, and such hospital owns or controls otherorganizations which furnish physical therapy services so long asthe referral is to such owned or controlled organization and thephysician does not also have a direct or indirect ownership orinvestment interest in such organization, physical therapyservice, or the hospital and the referring physician does notreceive any remuneration as the result of the referral.
3. The provisions of sections 334.252 and 334.253 shallbecome effective January 1, 1995.
(L. 1992 H.B. 1377 § 1 subsecs. 2, 3, § 2)Effective 1-1-95