The Stark Law is a set of regulations that all physicians and physician lawyers must understand and deal with on a daily basis. This law exists to prevent a conflict of interest between providers and their patients, with violations producing serious penalties to those who are found to be in violation; however, these regulations can be confusing depending upon the circumstances. Health care lawyers advise their physician clients to study these regulations and how they may apply to them, then speak with an experienced attorney to prevent any unintentional violations.
What Is The Stark Law?
The Stark Law is a group of federal laws that prohibit a physician from making a self-referral or any referrals that could otherwise be financially beneficial to them. This type of connection is recognized by lawmakers and health care lawyers as a direct conflict of interest and has been deemed unlawful. These regulations protect patient and insurer interests without actually preventing a physician from collecting appropriate fees, provided they do not engage in the practice of self-referral.
What Is Considered To Be A Violation?
The Stark Law provisions deal with the referral of patients by providers participating in what is generally considered to be “fee for service” arrangements where there is some kind of monetary gain made through a referral. Based on this set of regulations, lawyers know that it is unlawful for a doctor to refer a patient to any provider or service from which they or a family member directly or indirectly receive some type of benefit.
This includes situations where a physician or family member is an owner or partial owner, has an investment in, or receives some kind of compensation from a medical facility in exchange for the referral. Implications are complex and in some cases, even extend to include leased medical equipment that offers a kickback based on its use. Physician lawyers stress that Stark Law regulations extend to Medicare and Medicaid patients, making it unlawful for any participating physician to self-refer simply because of their participation in these federal aid programs.
When Is A Physician Not In Violation?
Although the above description of Stark Law violation seems fairly straightforward, the law does get confusing in certain situations. Health care lawyers point out that while physicians cannot refer to such facilities or order services based on the receipt of a kickback, their patients may still obtain services from these providers. When a patient chooses a service that the physician is associated with on their own, without any kind of referral, this is not viewed as a violation. Patients may obtain their services from any suitable facility, regardless of a physician’s association to that facility, when there is no actual suggestion that they do so.
The goal of the Stark Law provisions is to promote the fair collection of fees in the medical industry while ensuring all patients still receive appropriate care from necessary providers. Yet health care lawyers warn that physicians must understand this set of regulations in order to avoid circumstances where they may inadvertently violate them, such as through the leasing of certain equipment or participation in Medicare or Medicaid. It is recommended that every doctor discuss the Stark Law with an experienced physicians lawyer to protect themselves and to avoid making a mistake that could result in serious penalties.
The Stevenson Law Firm, PC
6302 W. Broadway, Suite 120
Pearland, TX 77581
Phone: (832) 481-4548