{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/54.1-2413.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/54.1-2413.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/54.1-2413.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/54.1-2413.html"}],"law_id":86817,"edition_id":1,"section_id":86817,"structure_id":13237,"section_number":"54.1-2413","catch_line":"Additional conditions related to practitioner-investors","history":"1993, c. 869; 2005, c. 402; 2010, c. 743.","full_text":"A\n\nNo hospital licensed in the Commonwealth shall discriminate against or otherwise penalize any practitioner for compliance with the provisions of this chapter.B\n\nNo practitioner, other health care worker, or entity shall enter into any agreement, arrangement, or scheme intended to evade the provisions of this chapter by inducing patient referrals in a manner which would be prohibited by this chapter if the practitioner made the referrals directly.C\n\nNo group practice shall be formed for the purpose of facilitating referrals that would otherwise be prohibited by this chapter.D\n\nNotwithstanding the provisions of this chapter, a practitioner may refer a patient who is a member of a health maintenance organization to an entity in which the practitioner is an investor if the referral is made pursuant to a contract with the health maintenance organization.E\n\nNotwithstanding the provisions of this chapter, a referral to an entity in which the referring practitioner or his immediate family member is an investor shall not be in violation of this chapter if (i) the health service to be provided is a designated health service as defined in 42 U.S.C. § 1395nn (h)(6), as amended, and an exception authorized by 42 U.S.C. § 1395nn, as amended, or any regulations adopted pursuant thereto, applies, or (ii) the health service to be provided is not a designated health service as defined in 42 U.S.C. § 1395nn (h)(6), as amended, but would qualify for an exception authorized by 42 U.S.C. § 1395nn, as amended, or any regulations adopted pursuant thereto, if the health service were a designated health service.","order_by":null,"text":{"0":{"id":310873,"text":"No hospital licensed in the Commonwealth shall discriminate against or otherwise penalize any practitioner for compliance with the provisions of this chapter.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":310874,"text":"No practitioner, other health care worker, or entity shall enter into any agreement, arrangement, or scheme intended to evade the provisions of this chapter by inducing patient referrals in a manner which would be prohibited by this chapter if the practitioner made the referrals directly.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":310875,"text":"No group practice shall be formed for the purpose of facilitating referrals that would otherwise be prohibited by this chapter.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":310876,"text":"Notwithstanding the provisions of this chapter, a practitioner may refer a patient who is a member of a health maintenance organization to an entity in which the practitioner is an investor if the referral is made pursuant to a contract with the health maintenance organization.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":310877,"text":"Notwithstanding the provisions of this chapter, a referral to an entity in which the referring practitioner or his immediate family member is an investor shall not be in violation of this chapter if (i) the health service to be provided is a designated health service as defined in 42 U.S.C. § 1395nn (h)(6), as amended, and an exception authorized by 42 U.S.C. § 1395nn, as amended, or any regulations adopted pursuant thereto, applies, or (ii) the health service to be provided is not a designated health service as defined in 42 U.S.C. § 1395nn (h)(6), as amended, but would qualify for an exception authorized by 42 U.S.C. § 1395nn, as amended, or any regulations adopted pursuant thereto, if the health service were a designated health service.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D"}},"ancestry":[{"id":13237,"edition_id":1,"name":"Practitioner Self-Referral Act","identifier":"24.1","label":"chapter","depth":3,"order_by":1,"parent_id":12758,"metadata":{},"date_created":"2026-06-26 03:44:30","date_modified":"2026-06-26 03:44:30","permalink":{"id":241285,"object_type":"structure","relational_id":13237,"identifier":"24.1","token":"54.1\/III\/24.1","url":"\/54.1\/III\/24.1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12758,"edition_id":1,"name":"Professions and Occupations Regulated by Boards Within the Department of Health Professions","identifier":"III","label":"subtitle","depth":2,"order_by":1,"parent_id":12754,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":241105,"object_type":"structure","relational_id":12758,"identifier":"III","token":"54.1\/III","url":"\/54.1\/III\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12754,"edition_id":1,"name":"Professions and Occupations","identifier":"54.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":239313,"object_type":"structure","relational_id":12754,"identifier":"54.1","token":"54.1","url":"\/54.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":87158,"structure_id":13237,"section_number":"54.1-2410","catch_line":"Definitions","url":"\/54.1-2410\/","token":"54.1\/III\/24.1\/54.1-2410","metadata":false},{"id":82894,"structure_id":13237,"section_number":"54.1-2411","catch_line":"Prohibited referrals and payments; exceptions","url":"\/54.1-2411\/","token":"54.1\/III\/24.1\/54.1-2411","metadata":false},{"id":63182,"structure_id":13237,"section_number":"54.1-2412","catch_line":"Department to administer; powers and duties of Department; penalties for violation","url":"\/54.1-2412\/","token":"54.1\/III\/24.1\/54.1-2412","metadata":false},{"id":86817,"structure_id":13237,"section_number":"54.1-2413","catch_line":"Additional conditions related to practitioner-investors","url":"\/54.1-2413\/","token":"54.1\/III\/24.1\/54.1-2413","metadata":false},{"id":54241,"structure_id":13237,"section_number":"54.1-2414","catch_line":"Applicability of chapter; grace period for compliance","url":"\/54.1-2414\/","token":"54.1\/III\/24.1\/54.1-2414","metadata":false}],"previous_section":{"id":63182,"structure_id":13237,"section_number":"54.1-2412","catch_line":"Department to administer; powers and duties of Department; penalties for violation","url":"\/54.1-2412\/","token":"54.1\/III\/24.1\/54.1-2412","metadata":false},"next_section":{"id":54241,"structure_id":13237,"section_number":"54.1-2414","catch_line":"Applicability of chapter; grace period for compliance","url":"\/54.1-2414\/","token":"54.1\/III\/24.1\/54.1-2414","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/54.1-2413\/","history_text":"

This law was first created in 1993. The record of its establishment is cataloged in chapter 869 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1993 \u201cActs\u201d aren\u2019t available online. It has been modified 2 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 2005, chapter 402<\/a>; in 2010, chapter 743<\/a>.<\/p>","references":[{"id":82894,"section_number":"54.1-2411","catch_line":"Prohibited referrals and payments; exceptions","order_by":null,"url":"\/54.1-2411\/"}],"refers_to":false,"permalink":{"id":241299,"object_type":"law","relational_id":86817,"identifier":"54.1-2413","token":"54.1\/III\/24.1\/54.1-2413","url":"\/54.1-2413\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/54.1-2413\/","token":"54.1\/III\/24.1\/54.1-2413","dublin_core":{"Title":"Additional conditions related to practitioner-investors","Type":"Text","Format":"text\/html","Identifier":"\u00a7 54.1-2413","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> No hospital licensed in the Commonwealth shall discriminate against or otherwise penalize any practitioner<\/span> for compliance with the provisions of this chapter. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> No practitioner<\/span>, other health care worker, or entity<\/span> shall enter into any agreement, arrangement, or scheme intended to evade the provisions of this chapter by inducing patient referrals<\/span> in a manner which would be prohibited by this chapter if the practitioner<\/span> made the referrals<\/span> directly. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> No group practice<\/span> shall be formed for the purpose of facilitating referrals<\/span> that would otherwise be prohibited by this chapter. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Notwithstanding the provisions of this chapter, a practitioner<\/span> may refer a patient who is a member of a health maintenance organization to an entity<\/span> in which the practitioner<\/span> is an investor<\/span> if the referral<\/span> is made pursuant to a contract<\/span> with the health maintenance organization. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Notwithstanding the provisions of this chapter, a referral<\/span> to an entity<\/span> in which the referring practitioner<\/span> or his immediate family member<\/span> is an investor<\/span> shall not be in violation of this chapter if (i) the health service to be provided is a designated health service as defined in 42 U.S.C. § 1395nn (h)(6), as amended, and an exception authorized by 42 U.S.C. § 1395nn, as amended, or any regulations adopted pursuant thereto, applies, or (ii) the health service to be provided is not a designated health service as defined in 42 U.S.C. § 1395nn (h)(6), as amended, but would qualify for an exception authorized by 42 U.S.C. § 1395nn, as amended, or any regulations adopted pursuant thereto, if the health service were a designated health service. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nADDITIONAL CONDITIONS RELATED TO PRACTITIONER-INVESTORS (\u00a7 54.1-2413)\n\nA. No hospital licensed in the Commonwealth shall discriminate against or\notherwise penalize any practitioner for compliance with the provisions of this\nchapter.\n\nB. No practitioner, other health care worker, or entity shall enter into any\nagreement, arrangement, or scheme intended to evade the provisions of this\nchapter by inducing patient referrals in a manner which would be prohibited by\nthis chapter if the practitioner made the referrals directly.\n\nC. No group practice shall be formed for the purpose of facilitating referrals\nthat would otherwise be prohibited by this chapter.\n\nD. Notwithstanding the provisions of this chapter, a practitioner may refer a\npatient who is a member of a health maintenance organization to an entity in\nwhich the practitioner is an investor if the referral is made pursuant to a\ncontract with the health maintenance organization.\n\nE. Notwithstanding the provisions of this chapter, a referral to an entity in\nwhich the referring practitioner or his immediate family member is an investor\nshall not be in violation of this chapter if (i) the health service to be\nprovided is a designated health service as defined in 42 U.S.C. § 1395nn\n(h)(6), as amended, and an exception authorized by 42 U.S.C. § 1395nn, as\namended, or any regulations adopted pursuant thereto, applies, or (ii) the\nhealth service to be provided is not a designated health service as defined in\n42 U.S.C. § 1395nn (h)(6), as amended, but would qualify for an exception\nauthorized by 42 U.S.C. § 1395nn, as amended, or any regulations adopted\npursuant thereto, if the health service were a designated health service.\n\nHISTORY: 1993, c. 869; 2005, c. 402; 2010, c. 743.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}