54.1-2413 - Additional conditions related to practitioner-investors. - Virginia Statutes

§ 54.1-2413. Additional conditions related to practitioner-investors.

A. No hospital licensed in the Commonwealth shall discriminate against orotherwise penalize any practitioner for compliance with the provisions ofthis chapter.

B. No practitioner, other health care worker, or entity shall enter into anyagreement, arrangement, or scheme intended to evade the provisions of thischapter by inducing patient referrals in a manner which would be prohibitedby this chapter if the practitioner made the referrals directly.

C. No group practice shall be formed for the purpose of facilitatingreferrals that would otherwise be prohibited by this chapter.

D. Notwithstanding the provisions of this chapter, a practitioner may refer apatient who is a member of a health maintenance organization to an entity inwhich the practitioner is an investor if the referral is made pursuant to acontract with the health maintenance organization.

E. Notwithstanding the provisions of this chapter, a referral to an entity inwhich the referring practitioner or his immediate family member is aninvestor shall not be in violation of this chapter if (i) the health serviceto be provided is a designated health service as defined in 42 U.S.C. §1395nn(h)(6), as amended, and an exception authorized by 42 U.S.C. § 1395nn,as amended, or any regulations adopted pursuant thereto, applies, or (ii) thehealth service to be provided is not a designated health service as definedin 42 U.S.C. § 1395nn(h)(6), as amended, but would qualify for an exceptionauthorized by 42 U.S.C. § 1395nn, as amended, or any regulations adoptedpursuant thereto, if the health service were a designated health service.

(1993, c. 869; 2005, c. 402; 2010, c. 743.)