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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 entity.
The law against kickbacks is called the Anti-Kickback Statute or Stark Law, which makes it illegal for medical providers to refer patients to a facility owned by the physician or a family member for services billable to Medicare and Medicaid. It also prohibits providers to receive bribes for patient referrals.
The Anti-Kickback Statute [1] (AKS) is an American federal law prohibiting financial payments or incentives for referring patients or generating federal healthcare business. . The law, codified at 42 U.S. Code § 1320a–7b(b), [2] imposes criminal and, particularly in association with the federal False Claims Act, civil liability on those who knowingly and willfully offer, solicit, receive ...
The ability to self-refer is an incentive for physicians to order more tests than they otherwise might. In the United States, the Stark Law (specifically sections I and II) was designed to control self-referrals. [2] However, the exceptions designed to allow necessary testing in physicians' offices have been exploited to circumvent the law.
As of 2015, HHS-OIG had targeted hospitals and healthcare systems for Stark Law and Anti-Kickback Statute violations pertaining to the management of physician compensation arrangements. [79] In 2015, a fraud alert was issued to publicize the OIG's intent to further regulate such non-compliance. [80]
Thousands of patients insured through Humana's Medicare Advantage plans are no longer "in network" at Aultman hospitals.. Adam Luntz, senior vice president of finance at Aultman, said the contract ...
Claims under the law have typically involved government health care programs (Medicare, Medicaid and TriCare), military, or other government spending programs. FCA actions dominate the list of largest pharmaceutical settlements. Between 1987 and 2019, the government recovered more than $62 billion under the False Claims Act. [5]
The law forbids presidential impoundment of funds, but under certain circumstances allows a brief delay and gives the president means to ask Congress to reconsider an appropriation, known as ...