Philadelphia Health Care Lawyers: Is Congress Ready to Revise the Stark Law?

It seems that most physicians do not have a favorable opinion of the physician self-referral provisions, known as the Stark Law. The Stark law is actually three separate provisions that govern self–referral for Medicare and Medicaid patients. The law generally prohibits physicians from referring patients to facilities where they have ownership interests. It was initially intended to curb the overuse of Medicare and Medicaid. The law is named for Congressman Pete Stark, who sponsored the bill. However, health care providers are becoming increasingly weary of the complexities and penalties of the Stark law, Philadelphia health care lawyers, report. For those who feel this way, there is good news, as things may finally be changing.

A recent Senate Finance Committee report compiled stakeholder comments from a December 2015 roundtable discussion. There is a spectrum of suggestions suggested in the report. On one end, the report includes recommendations that the entire Stark law be repealed. Some have called this a noteworthy development, stating that just a few years ago, government officials would not have even contemplated a total repeal. On the other end of the spectrum, commenters focused on expanding Stark waiver and reducing penalty amounts for technical violations like unsigned or expired contracts.

Although the report did not posit any specific recommendations, it unequivocally acknowledged that the Stark law has become unnecessary and is hindering the transition from a fee-for-service model to value-based payment models designed to cut costs. Some experts have speculated that the Finance Committee will likely update the Stark law to help better define what constitutes technical violations and help the transition to new value-based payment models.

The health care industry in general has been expressing an increasing frustration with the intricate complexity of Stark law compliance procedures. The report squarely addresses many of these concerns. For instance, some recent settlement agreements suggest that any hospital-owned physician practice operating at a loss indicates that the physicians were paid more than fair market value, and the arrangement was not financially reasonable. Thus, it is an unfortunate side effect of Stark law compliance that any hospital experiencing a financial loss is open to allegations that it violated the Stark law, as long as there are physicians employed at that hospital.

Philadelphia Health Care Lawyers at Sidney L. Gold & Associates, P.C. Provide Effective Counsel Regarding Stark Law Violations

If you are seeking counsel regarding Stark Law compliance issues, the experienced Philadelphia health care lawyers at Sidney L. Gold & Associates, P.C. stay on the cutting edge of recent legal developments. With offices located in Center City Philadelphia, we serve clients throughout Pennsylvania, New York, and New Jersey. To schedule a consultation, call us at 215-569-1999 or complete our online contact form today.