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Disclosure of Financial Relationships Report
UPDATE APRIL 15, 2008: On April 10, 2008, the DFRR Survey was withdrawn. This appears to end the DFRR
Survey process for now. In the past CMS has claimed it has the authority both under the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 and under the Stark Law to require this type of survey. It remains to be seen whether
CMS will make additional attempts to conduct these audit activities or revive the DFRR, but for now the DFRR as proposed has been withdrawn.
The Centers for Medicare & Medicaid Services is implementing a new survey to investigate
the investment/ownership and compensation
arrangements between physicians
and hospitals to determine whether they are
in compliance with the physician self-referral
statute and implementing regulations. This new survey, entitled the Disclosure
of Financial Relationships Report
is mandatory and the 500 hospitals selected by CMS to participate will have 60
days in which to respond or face a penalty of
$10,000 per day for late responses.
Note that the initial DFRR release from CMS has been revised and reissued in September 2007. Bricker & Eckler has
prepared a bulletin on the revisions: CMS Issues Revised Stark Audit Survey - Will Be Sent to Hospitals in November
Resources Available
Letter From CMS to Hospital CEOs or CFOs
Sample letter being sent to 500 selected hospital chief executive officers or chief financial
officers announcing the survey -- Revised September 2007
Letter From CMS to Hospital CEOs or CFOs
Sample letter being sent to 500 selected hospital chief executive officers or chief financial
officers announcing the survey -- Revised September 2007
CMS Supporting Statement
Background and justification for the Disclosure of Financial Relationships Report
Requirement, Exception and Instructions
Instruction sheet for completing the Disclosure of Financial Relationships Report -- Revised September 2007
CMS Issues Revised Stark Audit Survey - Will Be Sent to Hospitals in November
October 2007
Bulletin on the revised Disclosure of Financial Relationships Report issued by CMS to survey hospital compliance with the Stark physician anti-referral laws.
Are Your Physician Contracts Stark Compliant? CMS is About To Find Out
July 2007
Bulletin by the Bricker & Eckler health law attorneys on the mandatory hospital Disclosure of Financial
Relationships Report survey from CMS. Note that this bulletin was prepared based on the initial DFRR release from CMS and does not
include the revisions of September 2007.
Comments from the American Hospital Association
July 2007 written comments to CMS regarding the Disclosure of Financial Relationships Report
The August 2006 CMS Report to Congress
The current mandatory survey has been developed as a result of the poor response rate
CMS received to an earlier voluntary survey sent to 130 specialty hospitals
and 320 acute care hospitals. In August 2006, CMS published
a report to Congress regarding the results
of this survey.
Final Report to Congress
Appendix 1 Scope and Methodology
Appendix II-1 Specialty Hospitals Receiving Survey
Appendix II-2 Acute Care Hospitals Receiving Survey
Appendix II-3 Hospitals Responding to Survey
Appendix III DRA Section 5006 Survey Instructions and
Supplemental Questions (Survey instrument not posted)
Appendix IV May 9, 2006 interim report to Congress
Appendix V Bibliography
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