Question: Why Is The Stark Law Important?

What is the purpose of Stark law?

The Physician Self-Referral Law, commonly referred to as the Stark law, prohibits physicians from referring patients to receive “designated health services” payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship, unless an exception applies..

Do Stark laws apply to employed physicians?

Both the Stark Law and the Anti-Kickback Statute contemplate employment of physicians by hospitals, and accordingly, both include an exception to accommodate the compensation paid by a hospital employer to a physician employee.

Who is a physician under Stark?

Who qualifies as a “physician” subject to Stark? The Phase I final regulations define “physician” as a doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor.

What is the difference between Stark and Anti Kickback?

The AKS prohibits referrals for any kind of item or service where a kickback is involved, while the Stark Law prohibits only the referral of designated health services where a financial interest is involved.

Which of the following is an example of a Stark law violation?

Violating the False Claims Act by paying or receiving bribes in connection with claims to the Medicare program. Having agreements with DPG to pay the group a percentage of Medicare payments for tests and procedures referred by DPG physicians.

Does Stark law apply to pharmacies?

The Stark Law applies to all relationships that physicians have with designated health services entities, and pharmacies are classified as such. Because of this, referral relationships between physicians and pharmacists can be scrutinized through the lens of the Stark Law.

What is the focus of the Stark law?

Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services (“DHS”) if the physician (or an immediate family member) has a financial relationship with that …

Who does the Stark law protect?

The Stark law prohibits a physician’s referral for certain designated healthcare services (DHS) to an entity if the physician (or a member of the physician’s immediate family) has a financial relationship with the entity, unless the referral is protected by one or more exceptions provided in the law.

How kickback arrangements would violate the Stark Law?

Kickbacks under Stark Law violations occur when healthcare providers provide financial incentives to other healthcare providers in order to receive referrals for Medicare or Medicaid.

Who does the Anti Kickback Statute apply to?

The federal Anti-Kickback Statute is a healthcare fraud and abuse statute that prohibits the exchange of remuneration—which the statute defines broadly as anything of value—for referrals for services that are payable by a federal program, which, in the context of healthcare providers, is Medicare.

What is a safe harbor under the Stark Act?

Proposed Stark Law Safe Harbors VBAs in which the VBE assumes full financial responsibility for the cost of all patient care items and services; VBAs in which a physician faces “meaningful,” but not full, financial risk; … Arrangements that involve the donation of cybersecurity technology and services.

What is a kickback violation?

The Anti-Kickback Statute and Stark Law prohibit medical providers from paying or receiving kickbacks, remuneration, or anything of value in exchange for referrals of patients who will receive treatment paid for by government healthcare programs such as Medicare and Medicaid, and from entering into certain kinds of …

What does the Sunshine Act do?

The Physician Payments Sunshine Act (PDF) is designed to increase transparency around the financial relationships (PDF) between physicians, teaching hospitals and manufacturers of drugs, medical devices and biologics.

What is Stark II law?

Stark II prohibits a physician or immediate family member who has a direct or indirect financial relationship with an entity from making referrals to that entity to provide designated health services (DHS) payable by Medicare or Medicaid, unless an exception applies.

What are the penalties for violating the Stark Law?

Penalties for violations of Stark Law include denial of payment for the DHS provided, refund of monies received by physicians and facilities for amounts collected, payment of civil penalties of up to $15,000 for each service that a person “knows or should know” was provided in violation of the law, and three times the …