What Is The Stark II Law?

What is the purpose of the Stark law?

The Stark Law is a healthcare fraud and abuse law that prohibits physicians from referring patients for certain designated health services paid for by Medicare to any entity in which they have a “financial relationship.” The federal government interprets the term “financial relationship” broadly to include any direct ….

Who does Stark Law apply to?

The Stark statute applies only to physicians who refer Medicare and Medicaid patients for designated health services to entities with which they (or an immediate family member) have a financial relationship. There are almost 20 exceptions to the Stark statute.

How does the Stark law impact physicians quizlet?

How does the Stark Law impact physicians? The Stark Law prohibits a physician from referring a patient for certain “designated health services” to an entity with which the physician has a “financial relationship.” In addition, a provider may not bill Medicare for a claim based upon a prohibited referral.

What are the exceptions to the Stark law?

Vaccines, immunizations, and screening tests are generally allowable Stark exceptions provided they aren’t given too often. The tests must be covered by Medicare. Intra-family rural referrals. Additionally, some referrals in rural areas are allowed if the services are for an immediate family member.

What is the difference between Stark and Anti Kickback?

The AKS prohibits referrals for any kind of item or service where a kickback is involved, while the Stark Law prohibits only the referral of designated health services where a financial interest is involved.

How does the Stark law impact physicians?

The Stark Law, also known as the physician self-referral law, prohibits a physician from referring Medicare or Medicaid patients for certain designated health services in which that physician (or the physician’s family member) maintains a financial interest.

Who does the Anti Kickback Statute protect?

The Anti-Kickback Statute and Stark Law prohibit medical providers from paying or receiving kickbacks, remuneration, or anything of value in exchange for referrals of patients who will receive treatment paid for by government healthcare programs such as Medicare and Medicaid, and from entering into certain kinds of …

What is an example of a violation of the Anti Kickback Statute?

Several healthcare providers have violated the Anti-Kickback Statute by offering investment interests, excessive compensation, or space and equipment deals to physicians that is designed to encourage the physician to refer patients or utilize a specific facility or healthcare services.

Do Stark laws apply to employed physicians?

Both the Stark Law and the Anti-Kickback Statute contemplate employment of physicians by hospitals, and accordingly, both include an exception to accommodate the compensation paid by a hospital employer to a physician employee.

What is the focus of Stark law?

Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services (“DHS”) if the physician (or an immediate family member) has a financial relationship with that …

What is an illegal provider relationship?

The Stark law prohibits a physician with a financial relationship in an entity from making a referral for designated health services covered by Medicare and Medicaid to that entity even if the services are billed to an individual or other third party payer.

What does Stark law mean?

Physician Self-Referral LawThe 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.

What is a safe harbor under the Stark Act?

Proposed Stark Law Safe Harbors VBAs in which the VBE assumes full financial responsibility for the cost of all patient care items and services; VBAs in which a physician faces “meaningful,” but not full, financial risk; … Arrangements that involve the donation of cybersecurity technology and services.

What is the discount safe harbor?

One of the recognized safe harbors to the Anti-Kickback Statute is “a discount or other reduction in price obtained by a provider of services or other entity under [Medicare or Medicaid] if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the provider or …