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The five most important Federal fraud and abuse laws that apply to physicians are the False Claims Act (FCA), the Anti-Kickback Statute (AKS), the Physician Self-Referral Law (Stark law), the Exclusion Authorities, and the Civil Monetary Penalties Law (CMPL).
When the Stark Law was enacted in 1989, healthcare was paid for primarily on a fee-for-service basis. Since that time, Medicare and the private market have implemented many value-based healthcare delivery and payment systems to address substantial cost growth in the current volume-based system.
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.
Stark Law aims to prevent conflicts of interest that could result in over-utilization of services, higher healthcare costs, and compromised patient care. While both Stark Law and the Anti-Kickback Statute address improper financial relationships in healthcare, Stark Law is a strict liability statute, meaning that intent does not need to be ...
The Physician Self Referral Law, more commonly known as the Stark Law, protects Medicare and Medicaid patients from receiving referrals based on financial interests.
Federal physician self-referral prohibition (42 USC 1395nn.), commonly referred to as the Stark law, is a set of regulations that pertain to physician self-referral under current United States (US) federal law.
The Stark Law, also known as the physician self-referral law, prohibits healthcare providers from referring Medicare patients for certain services to medical businesses where the provider has a financial interest.
The Stark Act, 42 U.S.C. § 1395nn, is a piece of legislation that was enacted to combat kickbacks to physicians for the referral of lab tests. Elsenety v. Health Care Fin. Admin., 85 Fed. Appx. 405, 409 (6th Cir. 2003).
The OIG Stark Law in healthcare is the section of the Social Security Act that prohibits physicians from referring Medicare and Medicaid patients to a non-exempted “designated health service” when the physician or an immediate family member has a financial interest in the service.
In what is likely the most substantial fraud and abuse rulemaking in over a decade, the US Department of Health and Human Services OIG and CMS published on November 20, 2020, long-awaited final rules changing the regulations addressing the AKS and CMP, and the Stark Law, respectively.