The use of the term directly effectively excludes independent contractors from the group practice for some purposes. However, under the definition of a physician in a group practice included in the Stark regulations contained in 42 CFR 411.351, an independent contractor is considered a physician in a group practice during the time he is performing patient care services for that practice. Additionally, independent contractors are considered part of a group practice under incident to billing rules. Where one or more laws or regulations consider independent contractors to be part of a group practice, it is ill-considered to exclude them from a group practice under other provisions. Group practices spend a great deal of time and money in an effort to comply with federal and state laws and regulations.
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