Stark Law Compliance
in 2011
满城风絮
Susan J. Freed
Davis Brown Law Firmcf鬼跳
What is “Stark”?
▪Prohibits physicians from referring federal government health care patients to entities in which they or their immediate family members have financial interests in for designated health rvices.
▪Must fit within a safe harbor or per illegal ▪Federal law limited to federal program beneficiaries
▪Some state laws (not IA)
Why Do We Have Stark?
▪Government believes if physicians have a financial interest in entities to whom they refer patients, this interest will incentivize them to refer patients and result in referring patients for tests/rvices that are n
ot necessary
校村炸鸡
Penalties for Violating Stark
▪Civil and criminal penalties
▪Exclusion from participating in
Medicare/Medicaid
▪Penalties are rising due to incread enforcement efforts
共享单车的好处▪Enforcement is lucrative for Medicare program
Determining if Stark is an Issue ▪Two part analysis in determining whether Stark is a problem
▪Is there a referral of a federal health care program patient for the provision of a designated health rvice?
▪Is there a financial relationship between the referring
physician (or family member) and the entity that will
provide the health rvice?
▪If the answer is yes than the referral is prohibited unless a safe harbor applies
▪No intent required
▪Blanket prohibition
Referral
▪Broad definition
▪Includes the request by a physician for a rvice or item covered by the government health care program, including consulting with another physician and any test or procedure ordered by or to be performed by or under the supervision of another physician
Financial Relationship
▪Ownership or investment interests
▪Compensation arrangements
▪Direct or Indirect
▪Includes indirect relationships such as relationships between a
hospital and group practice. An indirect relationship exists
between hospital and physician owners of group practice ▪Monetary or Non‐Monetary
▪Not just cash. Can be in‐kind items such as free rent.
Examples of Financial Relationships
▪Physician group practice owns an MRI
▪Hospital pays physicians for on‐call coverage ▪Physician rves as medical director of local nursing facility
▪Physician rents space in her office to another physician
Action Item # 1 –Identify Stark Issues ▪Identify “financial relationships” between physician practice and other providers/referral sources/entities to whom
physicians refer.
▪Hospitals
▪Other physicians
▪Hospices做蛋糕的英文
▪Home health agencies
正规租房合同范本>新疆好歌曲
▪Nursing facilities
▪ASCs
▪Laboratories/Diagnostic Imaging Providers
▪Therapy providers
▪Suppliers
婆婆也是妈
Action Item # 1‐Identify Stark Issues
▪Identify any “financial relationships” between individual physicians or their family members and providers/referral sources/entities to whom physicians refer.
▪Mandatory annual disclosure form
▪Ask for any $$ or in‐kind support that pass from physicians/family members and a provider, referral source or entity to whom physicians refer
