The Stark Law is a federal law which, in its first iteration, was first enacted in 1992. The general purpose of the law is to ensure that physicians are not personally profiting from referring patients to other medical providers. This law can be incredibly complex and interpretations of the law are still changing. Physicians must be aware of this law and what behavior is prohibited under it.
Benefits of The Stark Law
When the Stark Law was first passed, it defined a set of services or items which Congress believed were prone to over-utilization by physicians who had a financial relationship with the medical entity. The law prevented instances where a clinical laboratory service had a financial relationship with the doctor and where the services provided were reimbursable by Medicare. The basic premise of this act was to prevent unnecessary medical services which would ultimately result in financial kick-backs to the doctor. The kick-backs could be direct through a written agreement between the doctor and laboratory or it could be indirect if a family member was running or working at the clinical laboratory where the services were performed. Today, the law has been expanded to include other services to which a physician can refer patients including: occupational and physical therapy, speech therapy, radiology services including MRIs and other types of ultrasounds and scans, medical equipment and supplies, parenteral nutrients and related supplies, prosthetics, devices at ambulatory surgical centers, certain contact lenses, home health services, outpatient prescription drugs, inpatient and out-patient hospital services, and other items.
There are many other nuanced areas of the medical world where it is still unclear whether or not the Stark Law would prevent a referring relationship, and as a result, the Stark Law has been the subject of many lawsuits. Physicians and those who work with physicians must be aware of the Stark Law and its implementing regulations. This is an area where physicians must work closely with legal experts to fully understand the law and ensure compliance.
Additionally, physicians must be aware of whether they are prescribing drugs and referring patients to a pharmacy where the doctor’s family members may work. This could also be prohibited under the Stark Law if the pharmacy is reimbursed by Medicare. If technicians performing the radiology or other service have some sort of financial connection to the referring physician, there could be a violation of Stark Law. Therefore, as a physician develops new referral relationships in his or her network, they must be aware of the Stark Law and exactly what behavior violates the law.
Philadelphia Health Care Lawyers at Sidney L. Gold & Associates, P.C. Ensure Stark Law Compliance
This area of the law is still changing as more cases are litigated. Sidney L. Gold & Associates, P.C. stay current with developments and can provide the most up-to-date advice in this complex area of the law.
If you have a question about the Stark Law or you have been accused of violating the law, call our Philadelphia health care lawyers at 215-569-1999 or contact us online to schedule a consultation. Our experienced healthcare attorneys will review your case and help you determine your options and the best next steps.