Stark Law

Security Act (the Act) (42 U.S.C. 1395nn), also known as the physician self-referral law, or Stark Law, intends to prevent the misappropriation of or over utilization of healthcare that could result from incentivized diagnostic ordering protocols that may be a direct result of financial relationships that could influence healthcare decisions. The law is named for its author, United State Congressman Pete Stark, a Democrat from California, who authored and supported the creation of this piece of

Running head: THE STARK LAW The Stark Law Grand Canyon University HLT 418 May 7, 2009 Abstract In this paper we will define what the Stark law is, its purpose and benefit to the health care industry and some major points of how it has evolved over the years. The Stark law was originally enacted in order to prevent physicians or physician groups from abusing their self-referral programs. Since its conception, it has evolved into three separate provisions which will be discussed in detail

Stark Law is actually three separate provisions that govern physicians’ self-referrals, mostly for payment by Medicare patients; it is also known as “the self-referral law.” “The law is named for United States Congressman Pete Stark, who sponsored the initial bill (“STARK LAW,” n.d., para. 1). The first phase became effective on January 1, 1992 (Taromina, 2013, p. 83). It prohibited a physician from referring a patient to a clinical laboratory with which they, or an immediate family member, had a

CONTENTS Introduction 1 History of Stark Law 2 Key Concepts 3 General Prohibition Under Stark Law 3 Financial Relationships 4 Exceptions 4 Stark Law vs. Anti-kickback Statutes 4 Enforcement of Stark Law 5 Compliance with Stark Law 6 Examples of Problems 6 Compliance Plan 7 Risk of Not Making Repayments 8 Physician Recruitment 9 Conclusion 10 References 11 Introduction

Self-Referral (“Stark”) Law HSM410 Meghan Covert Devry University October 13, 2015 Physician Self-Referral (“Stark”) Law “What is needed is what lawyers call a bright line rule to give providers and physicians unequivocal guidance as to the arrangements that are prohibited. If the law is clear and the penalties are substantial, we can rely on self-enforcement. Few physicians will knowingly break the law. The Ethics in Patient Referrals Act provides this bright line rule” ~ Rep. Pete Stark Social Security

and Dr. V. violated the Stark Law. A brief synopsis of the case study, in efforts of maintaining revenues within the nuclear department Dr. S. and Dr. V., decided to lease a nuclear camera to refrain from referring patients to the local hospital, the actions of the physicians would result in the hospital losing a huge profit. To take a stance, the hospital refuted with a threat

Stark II and Medicare and Medicaid Program Protection Act of 1987 should be very familiar and important to any healthcare professional or institution. Any healthcare professional and or institution should always operate with the patient’s wellbeing and what decisions are best for the patient at all times. Stark II or Stark Law is violated when a healthcare professional refers a patient to an institution where he or she owns or has a financial interest in the referred medical establishment. Violation

The Stark Law Some federal statutes address fraud in government health care programs, and many of these laws vary considerably (Krause 2004). Some of these laws specifically target health care fraud. Example of the laws that the government direct at inappropriate health care activities includes the “Medicare and Medicaid Anti-Kickback Statute and Ethics in Patient Referrals Act (EPRA).” In 1989, Congress enacted the Ethics in Patient Referrals Act. Commonly known as Stark law, Congress named

this is the Stark Law. Simply speaking, this law prevents physicians of Medicare and Medicaid patients from making a referral to an entity in which they have a financial interest. In order to garner an increased understanding of this law it will be beneficial to look at a brief background. Prior to the passage of the Medicaid and Medicare bill of 1965, the government had little interest in physician billing or referring patterns. After the bill became into effect, however, several laws were implemented

may ask? When talking about healthcare fraud and abuse, we are talking about 2 major statutes in the healthcare industry, Physician Self-Referral (Stark) Law and AKS (Anti-Kickback Statutes). These laws apply to many practices and procedures within organizations and can be manipulated to benefit an organization financially. The Physician Self-Referral Law prohibits entities from presenting a claim to anyone for healthcare services for a service not rendered and it also prohibits a physician for creating