The list of what constitutes a designated health service dhs includes pt, rehab, diagnostic imaging, clinical lab. Stark law 2 stark law is a federal law in the united states which prohibits the physician selfreferral, precisely a physician referral of a medicare or medicaid patient entity offering designated health services especially if the surgeon has a financial relationship with that entity. This theft, in exchange for wiping out his debt and a fortune to pay his team of frustrated experts. Attorneys with knowledge of the stark law and other fraud and abuse laws should be. The stark law is related to, but not the same as, the federal antikickback law. In the final rule, cms finalized regulations previously proposed in july 2015 the proposed rule please. Prohibits a physician from making referrals for certain designated health services dhs payable by medicare to an entity with which he or she or an immediate family member has a. The law is named after united states congressman pete stark, who sponsored the initial bill in 1989. The stark law is a strict liability statute, meaning that proof of a physician s specific intent to violate the law is not required. Therefore there has been some condition since the beginning of this law, stark law was made for one purpose to ban a physician form making selfreferrals who can switch the health service that can be pay. Who is enforcing the stark law of the united states. The course provides an introduction to principles of sound legal analysis for incoming firstyear students. Stark law offices 101 w ohio st indianapolis, in lawyers.
Torrhen stark, known as the king who knelt, was a head of house stark who reigned as king in the north until aegon i targaryen invaded westeros with his dragons. The act prohibits physicians from making referrals to and laboratories from billing medicare for services ordered by. On october 30, 2015, the centers for medicare and medicaid services cms posted a final rule, which was published in the federal register on november 16, 2015 final rule, modifying the regulations implementing the federal physician selfreferral law stark law. Stark law is a set of united states federal laws that prohibit physician selfreferral, specifically a. Unlike the federal antikickback law,3 which is a criminal law prohibition focused on impermissible intent, stark is a strict liability civil statute. False claims, stark, anti kickback statute, and civil monetary penalties law duration. The oftenrevised stark law, also known as the ethics in patient referrals act, has but one basic intent. A comprehensive guide for the health care industry, attorneys and compliance professionals melvin ii, daniel h.
The stark law provides a safe harbor for those dhs entities that meet the academic medical centers exception. At that time, stark only applied to clinical laboratory services. Making sense of the stark law massachusetts medical society. The amc exception is extensive as it is complicated. Stark law violations can sometimes form the basis for false claims act litigation. What you need to know for 2016 posted on december 11, 2015 december 18, 2015 by jknight as 2015 draws to a close, the medjobnetwork blog has been recapping highlights from this past year as well as offering news, advice, and insight about what lies ahead for physicians in the coming year. Vital stark law considerations for physician employment. Stark law, also known as the ethics in patient referrals act of 1989 the act, became. Stark law for dummies pdf download gives the readers good spirit. The federal physician selfreferral law, normally known as the stark act, generally prohibits physicians and other healthcare professionals from referring their medicare and medicaid patients to facilities in which they or their immediate family members have an ownership or other. Cms finalizes two new exceptions and other modifications. Thus, the effect of the stark law is to prevent and reduce the occurrence of what is called physician selfreferral.
A users guide to achieving compliance, second edition. What is stark law and how does it affect a physicians. Although the content of stark law for dummies pdf download are difficult to be done in the real life, but it is still give good idea. Payments for the use of office space made by a lessee to a lessor if the arrangement meets the following requirements. The stark regs 1 forbid doctors and their immediate family members from referring their patients to businesses they own which provide designated health services, and 2 contains a long list of permitted financial relationships between health care providers. Unlike the stark law, failure to meet a safe harbor does not mean an arrangement automatically violates the antikickback statute or is illegal 5. Md rangers robust database combines verified hospital and facility data with proprietary data drawn from the founders thousands of fair. Stark law, also known as the federal physician selfreferral law, applies to any referrals a doctor makes to medicare and medicaid patients. Stark raving mad 1 hours and 41 minutes movie 2002 ben mcgewan has a deal with chinatowns nonchinese gang boss, gregory, to steal one of four mythical god statues reputed to give immense power. Public law 101239, informally known as stark i prohibited the referral of. A financial interest includes compensation, ownership and investment interests. Stark law for dummies pdf download gives the readers many references and knowledge that bring positive influence in the future. The physician selfreferral prohibition, commonly known as the stark law, is a complex set of regulations that has constantly expanded since its initial publication in 1995.
Stark law 101 by rachel ryan of iseman, cunningham. The five most important federal fraud and abuse laws that apply to physicians are the false claims act fca, the antikickback statute aks, the physician. Hccas catalog of books includes topics ranging from compliance 101 to healthcare privacy to research compliance. Stark law offices 101 w ohio st indianapolis in 46204. Physicians involved in any venture that may implicate stark should consult legal counsel. August 10, 1993 stark i is expanded to include the new stark ii provisions in section 562 of obra 93. Congress enacted the stark law as part of the omnibus budget reconciliation act of 1989. The law applies to any physician who receives payment from medicare, medicaid or another federal program. The stark law, 42 usc section 95nn, also referred to as the physician selfreferral law, has certain prohibitions when a physician or member of his or her immediate family has a direct or indirect financial arrangement or relationship with an entity. The stark law was created with the intention of preventing physicians from profiting off their own referrals. For foot and ankle surgeons, stark issues are mostly likely to be triggered by investments in ascs and group practice arrangements. It was name after the congressman peter stark, who was the original support of the bill. The stark laws passed in 1992 and expanded on in 1995 prohibit referral of a patient for designated health services to an entity in which the referring physician or a family member has a financial interest.
The genesis of the stark law, also known as the physician selfreferral law 42 u. Following are some highlights from the first article in this series the stark truth about the stark law. Over the next decade, cms published a series of regulations implementing the physician selfreferral law. Originally enacted in 1989, expanded in 1993 and finalized for the first time. Stark law is a set of united states federal laws that prohibit physician selfreferral, 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 entity the term referral means the request by a physician for the item or. There are different firms which offer information and support about the stark law. A comprehensive guide for the health care industry, attorneys and compliance professionals. I am an attorney with the office of inspector general. The nursing home law blog was launched in february 2007 and provides readers with a wide range of information pertaining to nursing homes, rehabilitation centers and assisted living facilities. The health care entrepreneurs guide to important laws. Stark law 2 the stark law is an intricate bill that was voted for the congress in 1989. The stark law should be contrasted with the antikickback statute, 42 u. He was named lord of winterfell and warden of the north after submitting to aegon during the war of conquest. Research compliance professionals handbook, 3rd edition.
Therefore, physicians who make prohibited referrals for designated health services even accidentally or unknowingly will still be subject to civil penalties. The stark law prohibits a physician from referring a medicare patient for certain designated health services to any entity in which the referring physician has a financial relationship. Today, there is a sprawling group of regulations and statutes collectively named stark law. Stark civil monetary penalties law cmpl state fraud and abuse laws antikickback laws selfreferral laws fee splitting patient brokering others apply if govt programs involved e. The physician antireferral law, or stark ii, or just the stark law, is the major federal law that deals with this aspect of healthcare practice. Compliance is not required, but affords protection under federalantikickback statute 6. The expansive use of the ioas exception by physicians in a manner not originally intended by the law undercuts the purpose of the law and substantially increases costs to the medicare program and its beneficiaries.
Making sense of the stark law compliance for the medical practice the information contained in this manual is intended to serve as a general resource and guide. An overview of the statute itselfregulations, specifically the regulatory exceptions, and the terms of the exceptionsthe source of interpretations of the stark law, including key cases and advisory opinions. Order online tickets tickets see availability directions. You deserve to work with a firm that offers integrity, reliability and personal commitment to finding the right. Browse our catalog to find out how to build an effective program and engage your employees, executive staff, and the board regarding healthcare compliance issues.
Requires adherence to both qualitative and quantitative standards. The law governs patient referrals for certain health services and prevents a doctor from referring patients to facilities where he or she holds a financial interest. It sounds simple, but the meanings of referral and financial relationship and are not entirely clear, making compliance with the statute a challenge. Section 1877 of the social security act the act 42 u. Stark law running head stark law 1 stark law monica cruz. Health care entrepreneurs need to know about the antikickback statute and stark. The stark law prohibits physicians from ordering designated health services dhs for medicare patients from entities with which the physician, or a family.
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