Home Health Care Agencies receiving reimbursement through Medicare must comply with significant regulatory requirements. One such requirement is the establishment of a group of professional personnel or professional advisory group. The failure to meet such requirement could jeopardize an agencies ability to receive reimbursement through the Medicare program or jeopardize their license to provide home health care services by the State of Illinois.

The group of professional personnel meets to advise the agency on professional issues, evaluate the agency's program and the provision of health care services, and maintain a liaison with other health care providers in the community. Such group also assists in the development of policy procedures for the administration of home health services provided by the agency. One member of the professional advisory group is required to be a physician. This provides any home health agency with an opportunity to establish a critical relationship with a physician. More importantly, if set up properly, the agency is permitted to compensate the physician.

Establishing a relationship with the physician provides an opportunity for the home health care agency to improve the agency's effectiveness. At the same time however, it is critical that any compensation structure with such physician does not violate Stark Law or anti-kickback provisions. Home health care agencies need to embrace this opportunity and in an effort to maximize its success.

When establishing a compensation arrangement with a physician it is critical that such relationship comply with specific regulations. Although it is permissible that the physician refer patients to the home health agency. In order not to violate the Stark Law Prohibition, certain regulations must be complied with. In particular the agreement must be in writing and the compensation arrangement must not be based upon the amount of referrals given to the agency. There are additional requirements that also must be considered. Any agency entering into a relationship with a physician must seek counsel from an attorney with expertise in Stark Law.

Home health agencies are obligated to establish a relationship with a physician in its group of professional personnel. This relationship provides the opportunity to develop a relationship with a physician in the community which could lead to a more successful agency. However, the agency must be careful to meet all applicable regulations so as not to jeopardize its license and right to receive reimbursement through Medicare.