The Stark Law Violation or Not
Answer: The Stark Law Violation or Not
The Stark Regulation is a “strict liability” law, which means that the law might be broken without a party’s purpose to promote referrals. An arrangement that does not really alter physician referrals, where the parties were oblivious or should have been aware that the claims were in violation of the Stark Law, and involves medically required services, could result in a Stark Law violation.
Unless an exception applies, the Stark Law prohibits:
- A physician is prohibited from referring certain Medicare-covered designated health services (“DHS”) to an entity with which he or she (or an immediate family member) has a financial relationship,
- and the entity receiving the referral is prohibited from submitting claims to Medicare for the referred services.
- The referral ban applies to referrals within a physician’s own practice and may include internal referrals from a practicing physician to their OEC if the referral is for DHS because a physician’s practice is a DHS business when it delivers DHS.
HCA 322 Week 4 Assignment, The Stark Law Violation or Not