Marcie Swenson
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Managing the compliance risks associated with physician financial relationships can be an overwhelming challenge for a compliance program.
“The Physician Self-Referral Law, commonly referred to as the Stark law, prohibits physicians from referring patients to receive "designated health services" payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship, unless an exception applies. Financial relationships include both ownership/investment interests and compensation arrangements. For example, if you invest in an imaging center, the Stark law requires the resulting financial relationship to fit within an exception or you may not refer patients to the facility and the entity may not bill for the referred imaging services.” –OIG HHS
Stark Law applies to the following designated health services:
- Clinical laboratory services
- Physical therapy services
- Occupational therapy services
- Outpatient speech-language pathology services
- Radiology and certain other imaging services
- Radiation therapy services and supplies
- Durable medical equipment and supplies
- Parenteral and enteral nutrients, equipment and supplies
- Prosthetics, orthotics and prosthetic devices and supplies
- Home health services
- Outpatient prescription drugs
- Inpatient and outpatient hospital services
The impact of a Stark Law or AKS violation has significant ramifications making physician financial relationships a high priority on your annual risk assessment and work plan.
Did you know that the Stark Law is “strict liability,” or that the AKS prosecutorial threshold changed the Affordable Care Act to “should have known?”
Tune into our free webinar, Physician Financial Relationships: Stark Law & Anti-Kickback Statute, with our very own compliance expert Marcie Swenson, to top off your knowledge of:
- Stark Law & AKS Comparison including common Exceptions & Safe Harbors
- Risks & Physician Lease Agreements
- Non-Monetary Compensation vs. Incidental Benefits
- Recent settlements, enforcement actions, and personal liability (DOJ Yates Memo)
- Office of Inspector General Fraud Alerts
- Recent Stark Law Changes
Questions or Comments?