Academic medical centers exception (42 CFR 411.355(e))

Background.
The phase I final rule provided an exception for financial relationships involving ownership and/or compensation arrangements with academic medical centers. Changes made in the phase II final rule pertaining to when compensation is deemed to be “set in advance” enables this exception to be used in connection with the  complex business and financial relationships in academic health care organizations . The phase III final rule made no significant changes to the exception’s requirements.

Requirements.
The academic medical center exception allows financial relationships involving services provided by an academic medical center as a result of a physician’s referral, as long as certain conditions are met. Those conditions are related to:

• The referring physician; 
• The compensation received by the referring physician;  
• Specific academic medical center requirements;
• What organizations qualify as an academic medical center; and
• The terms (implications) of the overall relationship.
  

Click on the links above to learn more about these specific requirements, and to assess the exception’s implications.