Ethics in Referrals and Billing Act

Summary

Ethics in Referrals and Billing Act - Amends the Public Health Service Act to establish a new title, Title XXVII: Physician Referral and Billing. Prohibits a physician from referring a patient to an entity in which the physician or an immediate family member has a financial relationship. Sets forth exceptions. Prohibits any patient from being required to pay for any service provided pursuant to a prohibited referral. Subjects a physician who makes referrals in violation of this Act to civil monetary penalties, suspension of laboratory certification for the lab of referral, and exclusion from participation in the Medicare program. Makes it unlawful, subject to exception, for any: (1) person who furnishes ancillary health services to present a bill to any person other than the patient receiving the services; or (2) physician to present a bill to any ancillary service recipient unless the services were furnished personally or under the supervision of the referring physician or a member of that physician's group practice or by individuals employed by that physician or group practice. Sets forth sanctions for violations of such restrictions.

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3 official files

• Introduced in Senate (text)

  Introduced in Senate · EN · 4 February 1993

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• Introduced in Senate (PDF)

  Introduced in Senate · EN · 4 February 1993

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• Introduced in Senate

  summary · EN · 4 February 1993

  Open at official source

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