49 Pa. Code § 45.3 – Disclosure of financial or ownership interest—statement of policy.

(a) Purpose. This statement of policy implements the act of May 26, 1988 (P. L. 403, No. 66) (35 P.S. § § 449.21—449.23).
(b) Requirement. A licensee of the Board referring a client for health-related services, devices or products to a business, service provider, facility or entity in which the licensee or a member of his family has a financial or ownership interest to any extent or degree, shall disclose that interest prior to making the referral, and shall notify the client of his freedom to choose an alternate provider.
(c) Guidelines for disclosure.
1. (1) Posting notice of disclosure requirement. It is recommended that compliance with the disclosure requirement include the prominent posting of a printed notice at least 8 1/2" x 11", legible from 3 feet, posted in the patient waiting area, as follows:
  TREATMENT IN THIS OFFICE MAY INCLUDE A REFERRAL FOR FURTHER HEALTH-RELATED SERVICES, DEVICES OR PRODUCTS. PENNSYLVANIA LAW REQUIRES ANY HEALTH-CARE PRACTITIONER TO DISCLOSE TO YOU ANY FINANCIAL INTEREST HE HAS IN ANY HEALTH-CARE FACILITY IN WHICH HE RECOMMENDS FURTHER HEALTH-RELATED SERVICES, DEVICES OR PRODUCTS. (ACT 66-1988)’’
2. (2) Written notice. When a licensee of the Board makes this type of referral, the licensee or a delegate shall advise the client and shall retain the following document in the patient’s file:
  I have been referred to
  for . I understand that my [licensee’s profession] has a financial interest in this business, and that I am free to choose an alternate provider. (signature of patient)