Department of Health and Human Services
The Centers for Medicare and Medicaid Services
ADVISORY OPINIONS
Section 1877(g)(6) of the Social Security Act (the Act) requires that the Centers for Medicare and Medicaid Services issue certain written advisory opinions. These opinions must discuss whether a physician's referrals relating to certain designated health services (other than clinical laboratory services) are prohibited under the Medicare program by section 1877 of the Act. We are making these advisory opinions available to the general public through this CMS website, as specified in our regulations at 42 CFR 411.384(b). The purpose of the advisory opinion process is to provide meaningful advice on how section 1877 of the Act applies to specific factual situations.
Please note that advisory opinions are binding only on the individuals or entities that have requested them and only requestors may rely on an advisory opinion. In each opinion we apply legal standards to a set of facts involving certain known persons. These known persons have provided specific statements about key factual issues. Because each opinion applies to specific individuals or entities in specific situations, no third parties are bound by, nor may they legally rely on, an advisory opinion.
In general, we have redacted specific information about the requesting individuals or entities, and about any individuals or entities associated with the requestor, to the extent that it is appropriate, for reasons of personal privacy and protecting confidential business information. However, we may include these kinds of information if the requestors and their associates have made it clear that the information need not be redacted and if there is no law prohibiting us from issuing it.
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AO-98-001;
October, 1998 -- Proposed Ambulatory Surgical Treatment Center
for [Material redacted] HealthCare, LLC.
- AO-98-002; November, 1998 -- Whether the partners and physician employees of a proposed partnership may, under the “in-office ancillary services” exception defined in section 1877(b)(2) of the Social Security Act (the Act), refer Medicare and/or Medicaid patients to the partnership for eyeglass prescriptions filled subsequent to cataract surgery with the insertion of an intraocular lens.
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