Does Stark Law only apply to Medicare?

August 25, 2020 Off By idswater

Does Stark Law only apply to Medicare?

KEY POINTS. 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.

What is the Stark II law?

Stark II prohibits a physician or immediate family member who has a direct or indirect financial relationship with an entity from making referrals to that entity to provide designated health services (DHS) payable by Medicare or Medicaid, unless an exception applies.

How does the Stark Law affect physicians?

This statute prevents fraudulent and unnecessary testing, referrals, and medical services. Additionally, it prevents physicians from seeking further personal financial or equity gains regarding patient care which is a clear conflict of interest. These limitations impact clinical decision-making and healthcare delivery.

What is the Stark Law also known as and why is it important to hospitals?

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.

What are two exceptions allowable under Stark?

There are two exceptions in the Stark statute relevant to these relationships: the bona fide employment relationship exception and the personal services arrangements exception (described later).

Who does the Anti-Kickback Statute apply to?

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 the difference between the Stark Law and the Anti-Kickback Statute?

Source of Prohibited Referrals: Whereas the Stark Law is only concerned with referrals from physicians, the Anti-Kickback Statute applies to referrals from anyone. In addition to civil sanctions, the Anti-Kickback Statute also provides for criminal punishment.

What is the Red Flags Rule healthcare?

The Red Flags Rule requires certain entities to develop and implement policies and procedures to protect against identity theft. Medical identity theft can also result in erroneous entries into existing medical records and can involve the creation of fictitious medical records in the victim’s name.

What are the exceptions under Stark?

For example, the following exceptions to the Stark Law require a written, signed agreement: office space and equipment rental, personal service arrangements, physician recruitment arrangements, group practice arrangements, and fair market value compensation arrangements.

What is a safe harbor under the Anti Kickback Statute?

2] The safe harbor regulations define payment and business practices that will not be considered kickbacks, bribes, or rebates that unlawfully induce payment by Medicare or Medicaid programs. The regulations specify allowable financial and referral relationships between physicians or other providers and suppliers.

Is Anti-Kickback a statute?

The federal Anti-Kickback Statute (AKS) (See 42 U.S.C. § 1320a-7b.) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs.

What is a safe harbor under the Anti-Kickback Statute?