Physician Owned Facilities
39-71-315, MCA, addresses the issue of physician owned or partially owned facilities. As more and more physicians are diversifying their practices it is important to remember 39-71-315 (1) (b). This section simply states that if a patient is referred to a facility owned wholly or in part by the physician , the provider must inform the patient of their ownership interest and provide the name and addresses of alternative facilities. Failure to comply can lead to fines of not less than $200.00 or more than $500.00 for each offense by the Montana Department of Labor and Industry.
39-71-315. Prohibited actions — penalty. (1) The following actions by a health care provider constitute violations and are subject to the penalty in subsection (2):
(a) failing to certify the provision of the services or treatment for which compensation is claimed under this chapter; or
(b) referring a worker for treatment or diagnosis of an injury or illness that is compensable under this chapter to a facility owned wholly or in part by the provider, unless the provider informs the worker of the ownership interest and provides the name and address of alternate facilities, if any exist.
(2) A person who violates this section may be assessed a penalty of not less than $200 or more than $500 for each offense. The department shall assess and collect the penalty. Penalties collected pursuant to this section must be paid into the state general fund. The workers’ compensation court has jurisdiction over actions brought to collect the penalty and over disputes concerning the penalty assessment. Disputes brought pursuant to this section are not subject to mediation.
(3) Subsection (1)(b) does not apply to medical services provided to an injured worker by a treating physician with an ownership interest in a managed care organization that has been certified by the department.
History: En. Sec. 16, Ch. 619, L. 1993; amd. Sec. 4, Ch. 516, L. 1995; amd. Sec. 11, Ch. 442, L. 1999; amd. Sec. 3, Ch. 69, L. 2005; amd. Sec. 16, Ch. 416, L. 2005; amd. Sec. 5, Ch. 167, L. 2011.