have an account?【sign in】Stark Law Violation Examples:A Guide to Stark Law Compliance in Physician Arrangements
huangauthorThe Stark Law, also known as the Physician Self-Revenue Prohibition, is a United States federal law that aims to prevent potential conflicts of interest in physician arrangements involving federally financed healthcare transactions. This law, which is part of the False Claims Act, prohibits healthcare providers from earning certain remuneration related to patient referrals for certain designated healthcare services. In this article, we will explore some common Stark Law violation examples and provide guidance on how to comply with the law in physician arrangements.
Stark Law Basics
The Stark Law prohibits healthcare providers from receiving remuneration related to patient referrals for designated healthcare services, including laboratory tests, radiology services, and inpatient and outpatient hospital services. Designated healthcare services are those for which Medicare or Medicaid reimbursement is available. Remuneration includes any form of compensation, such as salaries, bonuses, and professional fees.
Stark Law exceptions include compensation for expenses, certain bona fide employment relationships, and compensation based on independent decision making. Healthcare providers must carefully review the terms of their arrangements and comply with the Stark Law to avoid potential penalties and litigation.
Stark Law Violation Examples
1. Compensation based on patient referrals
One of the most common Stark Law violations is receiving remuneration based on patient referrals. This includes compensation related to the number or value of patient referrals. If a healthcare provider receives compensation based on patient referrals, there is a high likelihood of a Stark Law violation.
2. Compensation for designated healthcare services
Compensation for designated healthcare services is also a common Stark Law violation. This includes compensation for laboratory tests, radiology services, and inpatient and outpatient hospital services. If a healthcare provider receives compensation for providing designated healthcare services, there is a high likelihood of a Stark Law violation.
3. Compensation based on independent decision making
Compensation based on independent decision making is an exception to the Stark Law. However, healthcare providers must demonstrate that they made their decisions independently and without consideration of the possibility of patient referrals. If a healthcare provider receives compensation based on independent decision making, but cannot prove that they made their decisions independently, there is a high likelihood of a Stark Law violation.
Guidelines for Complying with the Stark Law
To avoid Stark Law violations, healthcare providers should follow these guidelines:
1. Review all physician arrangements for compliance with the Stark Law. This includes compensation, employment relationships, and any other arrangements involving designated healthcare services.
2. Ensure that compensation is based on expenses, employment relationships, or other exceptions to the Stark Law. Compensation based on independent decision making is an exception, but healthcare providers must demonstrate that they made their decisions independently and without consideration of the possibility of patient referrals.
3. Properly document all arrangements and compensation to demonstrate compliance with the Stark Law. This includes maintaining accurate records of patient referrals, expenses, and compensation.
4. Regularly monitor all physician arrangements for potential compliance issues. This includes regular reviews of compensation, employment relationships, and other arrangements involving designated healthcare services.
5. Seek legal advice if you have concerns about compliance with the Stark Law. An experienced healthcare attorney can help you understand the law and provide guidance on how to comply with the Stark Law in your physician arrangements.
The Stark Law is a complex and highly regulated area of healthcare law that requires healthcare providers to carefully review and comply with the law in all physician arrangements. By understanding the basics of the Stark Law and following these guidelines for compliance, healthcare providers can avoid potential penalties and litigation and ensure that they are operating within the law in their physician arrangements.