Philadelphia Health Care Lawyers

Sidney L. Gold & Associates defend Physicians Charged with Violations of Stark Laws

The Stark law is a federal statute that prohibits physicians from referring Medicare patients and clients to medical service facilities where they hold a financial interest, or have immediate relatives financially associated with the facility. The practice of referring patients to facilities where the physician owns, invests, or has a monetary connection is called physician self-referral. The Stark law was sponsored by Congressman Pete Stark, and was initiated to discourage overuse of services within a referral system that would virtually limit competition from outside providers.

The Stark Law differs from federal anti-kickback laws in that it only prohibits physician referrals, not referrals from other health care providers or facilities. The specific designated health services (DHS) that are affected by the Stark Laws include radiology and imaging services, clinical lab services, occupational therapy, physical therapy, speech/language pathology, radiation therapy, medical equipment and supplies such as walkers, wheelchairs, canes, crutches, and hospital beds, prosthetics, prescriptions, along with inpatient/outpatient hospital services. Referrals from physicians to these types of medical service facilities in which the physician or immediate family member holds a financial interest are called prohibited referrals.

Exceptions to Stark Laws Banning Physician Self Referrals

As with most federal laws, there are exceptions to the Stark Laws that exist in various written agreements. The in-office ancillary services agreement allows physicians to refer Medicare patients to another doctor in their practice for medical services or testing so long as they are located at the same location as the referring physician. This agreement allows the medical team to easily and efficiently coordinate a patient’s medical care.

In some cases, health care providers can offer physicians or immediate family members professional courtesy services, which can include discounted or free services. Certain ultrasound, office or equipment leases, and office space rentals can be included in Stark Law exceptions. Compensation packages in qualified employment arrangements and non-financial compensation benefits not exceeding $300 in value can also qualify as Stark Law exceptions in some instances.

Civil Penalties for Violations of Stark Laws

Physicians charged with violating federal Stark Laws face costly criminal and civil penalties and possible jail time. Violators can be required to repay Medicare at a rate of $15,000 per service rendered, and $100,000 for prohibited referrals. Physicians guilty of violating the Stark Laws can also be mandated to repay Medicare all money earned from referrals submitted during the violation period, up to three times the total amount declared.

Relationships that raise red flags for possible Stark Law violations include physician employment and independent contractor agreements, equipment and office/space leasing agreements, medical directors and hospital/physician recruitment agreements, and physician arrangements with DHS providers, such as home health care businesses and medical equipment suppliers. Hiring a competent and experienced health care lawyer to review or initiate careful consultation in these types of relationships is crucial to avoiding penalty.

Philadelphia Stark Law attorney, Sidney L. Gold is committed to providing his clients with the opportunity to utilize his experience and knowledge in health care and employment law to devise the best legal strategy for their defense. No matter what the circumstances are that surround a particular case, Sidney L. Gold will personally commit himself to his client’s successful outcome.

Philadelphia Health Care Lawyer, Sidney L. Gold Offers Personalized Service and Individual Attention to Physicians Facing Stark Law Violations

For over 35 years, the Philadelphia health care lawyers at Sidney L. Gold & Associates have counseled and defended physicians and health care organizations on how best to manage and operate their medical practices to avoid Stark Law violations. Penalties are stiff for violations to the law, and costly fines can quickly impact a physician’s financial well-being and that of their practice. Sidney L. Gold, founder and shareholder of Sidney L. Gold & Associates, is now offering a unique legal service to those most affected by health care reform and regulations. In this concierge structure, Sidney L. Gold provides his clients with the best opportunity to fully access and utilize his experience and knowledge to ensure the best possible outcome.

If you or someone you know have been charged with violating Stark Laws, we can help. Call us at 215-569-1999, or complete our online contact form to schedule a consultation today. With offices located in Center City Philadelphia, we serve clients throughout Pennsylvania, New York and New Jersey.