In 2006, the federal government relaxed requirements for physicians who accept donations of electronic health record (EHR) and ePrescribing technology and services from hospitals and other health care providers to which they refer patients. Physicians can accept donations under the relaxed requirements without violating federal fraud and abuse laws.
The requirements are set forth in special exceptions to the Physician Self-Referral (Stark) Law and safe-harbors to the Anti-Kickback Statute. Without these exceptions and safe-harbors, the donations might be construed as illegal payments for referrals.
See the table below for an outline of the donations covered by the exceptions and safe-harbors.
Quick facts on EHR/e-prescribing exceptions and safe harbors
| The scope of donors and recipients |
| EHR/EMR | e-prescribing |
| Any covered entity to which the physician refers patients. | Limited to: - Hospitals donating to members of their medical staffs
- Group practices donating to physician members
- Prescription drug plan sponsors and Medicare Advantage organizations donating to prescribing physicians
|
| Covered technology and services |
| EHR/EMR | e-prescribing |
| Any software, information technology, and training services (but not hardware) that are "necessary and used predominately to create, maintain, transmit, or receive EHR.” It must contain an ePrescribing component or the ability to interface with an ePrescribing system.
Examples include: - Interface and translation software for use within an organization
- Licenses for software
- Connectivity services, such as broadband and wireless
- Maintenance and other support services directly related to EHR
| Hardware, software, information technology, and training services that are "necessary and used solely to transmit and receive electronic prescription information." It must be used for ePrescribing, and the physician cannot already possess the same technology.
Donated items and services must be provided as part of, or be used to access, an electronic prescription drug program that meets Medicare Part D standards. |
Some of the additional requirements for donations include:
- A written agreement, which specifies the items and services to be provided and the donor’s cost.
- EHR technology must be interoperable at the time of the donation
- EHR recipients must pay at least 15 percent of the donor's cost.
- Protections for donated EHR technology and services expire Dec. 31, 2013.
More information
For more information, visit the following websites: