The Stark Law exceptions generally provide exceptions for ancillary services provided certain conditions are met. The Anti-Kickback Statute and Stark Law are in place to ensure that medical services and recommendations remain as free from financial influence as possible. 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. As such, they are particularly sought-after targets for kickback schemes. xbbbd`b``3D? Immediate family members are individuals directly related to physicians. These payments can be accepted (with conditions) without having a written agreement. Doctors, medical practices, and medical companies can also be penalized again for violation of the Anti-Kickback Statute or Stark Law. This means that when Medicare, Medicaid, VA, or TRICARE funds are involved, if you are a medical professional and accept payment or other remuneration such as free accommodations, meals, travel, or excessively high compensation for speaking engagements in exchange for medical referrals, you may be in violation of the Anti-Kickback Statute. Stark Law essentially prohibits a physician from making referrals to a patient for a particular designed healthcare service that is payable by Medicare or Medicaid to an The new regulations for value-based payments focus on the risk the health provider is taking. This means that a referral for a private-pay (or even self-pay) patient would not fall under the laws requirements. Even non-intentional connections involving financial ties may be in violation of the Stark Law. Stark Law and AKS Concerns for Medical Laboratories The law only applies to Medicare patients seeking designated health services. We shared summarised but crucial information about Physician Self-Referral Law (Stark Law) for your reference. Updating the definition of overall profits, in various respects such as where the group has at least five physicians and the requirements for paying productivity bonuses. As an example, let's say that a general practitioner has a spouse who owns a home health care service. For more information, speak to a qualified qui tam lawyer to understand what kinds of proof are necessary and allowable by law. Such reactions are understandable given how easy it is to violate the law and how severe the penalties are. The doctor's patient needs to receive some continuing outpatient care, and is covered by Medicare. The Ghost of Robinson-Patman Rises at the FTC, Indiana To Be Next in Passing Consumer Privacy Statute, U.S. Executive Branch Update April 17, 2023. DO YOU KNOW THE KEY DIFFERENCES BETWEEN THE 4 AMBULATORY SAFE-HARBORS TO THE FEDERAL ANTI-KICKBACK STATUTE (AKS)? Congress has then seen that physicians were taking advantage of the overall healthcare costs by ordering additional, often medically unnecessary laboratory tests, where they unjustly enriched themselves. Under the purposes of the Stark Law, the following medical professionals are considered physicians: medical doctors, osteopathy, optometry, dental medicine, dental surgery, podiatric medicine, plus chiropractors. WebThe Texas House approved Wednesday a bill that would expand eligibility to people who suffer from chronic pain to the states medical marijuana program. The Centers for Medicare and Services (CMS) is the federal agency primarily responsible for enforcing Stark Law. The Office of the Inspector General (OIG) is tasked to investigate suspected healthcare fraud activities and report cases to the U.S. Department of Justice (DOJ) for criminal or civil actions. Other changes were made effective January 1, 2022, to give physicians time to come into compliance. 0000003067 00000 n Our health law attorneys regularly counsel medical and diagnostic lab owners and marketers on Stark Law and Anti-Kickback Statute compliance. The value-based safe harbors are generally narrower than the Stark exceptions.. The Stark law may impede certain pay for performance value-based arrangements, which led to discussions around reform as of 2019.[6]. In recent years, the laws of the United States have undergone a whistleblower revolution. 0000001893 00000 n You can even refer to the CMS document on Physician Self-Referral Law: Frequently Asked Questions for detailed understanding. No. endstream endobj 154 0 obj <>/Size 122/Type/XRef>>stream Lets review some examples of the law in practice: 1) Amedisys Home Health: This home health services provider agreed to pay $150 million to settle a lawsuit that alleged it intentionally violated the False Claims Act and the Stark Law by submitting unlawful and unnecessary claims to Medicare from 2008 to 2010. The world has seen how the American economy leads its progress in technological innovations and far-reaching inventions, particularly in the healthcare system. Parenteral and enteral nutrients, equipment, and supplies. endstream endobj 123 0 obj <>/Metadata 4 0 R/Pages 3 0 R/StructTreeRoot 6 0 R/Type/Catalog/Lang(en-US)>> endobj 124 0 obj <>/MediaBox[0 0 612 792]/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]>>/Type/Page>> endobj 125 0 obj <> endobj 126 0 obj <> endobj 127 0 obj <>stream Under certain state laws the following statements may be required on this website and we have included them in order to be in full compliance with these rules. WebThe Stark statute has generated confusion and anxiety among physicians. 0000103637 00000 n Your healthcare lawyer can explain the requirements to meet this exemption in more detail. WebSark: A project focused upon the opportunities to share support services and other non-frontline medical services (e.g., pathology), and rationalise estates across the four Outer South East London Trusts (BHT, QEH, QMS and University Hospital Lewisham). 1395nn). 0000006724 00000 n The law also prohibits the billing of Medicare or other insurance providers for health services when an improper physician referral was made. Stark concentrates her practice in the representation of start-up and emerging companies and non-profit organizations on a variety of issues including corporate formation, financing, franchising, licensing, acquisitions, executive compensation, equity compensation plans, employment agreements, real estate and intellectual property law. It allows you to avoid incurring fines by steering clear of unlawful self-referrals in the medical industry. As a part of the settlement, the court awarded Seddon approximately $200,000. It initially applied to physician referral for clinical laboratory services and later expanded in 1995 to cover designated health services. 0000103387 00000 n Prosthetics, orthotics, and prosthetic devices and supplies. Services not listed here are not covered under the Stark Law and are therefore not subject to its requirements or penalties. Multiple federal entities oversee enforcement of Stark Law. eJM3 0 QM WebIn many respects, the Stark Law exception for renting equipment is similar to the exception for office space. If the doctor in question refers the patient to their spouse's company - even if doing so is not motivated by financial gain - they are in violation of the Stark Law. 2) The law also prohibits the billing of Medicare or other insurance providers for health services when an improper physician referral was made. Stark II is Phase II of the law that prohibits physician self-referrals. WebPhysician self-referral law, 42 USC 1395nn Medicare A law that prohibits a physician from making a referral to an entity with which she or her immediate family has a financial Note that there are certain exceptions to this law. By implementing effective compliance controls and drafting contracts that abide by all the components of the safe harbor provisions, HCPs can reduce and even eliminate their chances of violating this law. 1877 of the Social Security Act and Title 42, Sec. WebPosted in Medical Malpractice Consider the following scenario: A patient is given pain medication in a hospital emergency room which impairs the ability to operate a motor vehicle. Kickbacks are not always the direct exchange of funds. These types of referrals are prohibited by law because these designated health services are generally payable by Medicare or Medicaid, which are federal healthcare programs. 0000000016 00000 n The Stark Law guides physicians to practice their profession with integrity. What are some common exceptions for Stark Law? Khouri Law counsels are intellectually equipped, highly competent, and quality-driven attorneys in litigating healthcare fraud cases. Electronic Health Records Items and Services. When the Stark Law was enacted in Tuomey, a South Carolina-based healthcare system, was found guilty of Stark Law violations. Whether you work in a doctor's office, in a billing department of a healthcare group or insurance provider, you may be able to report on your employer and be protected against possible retaliation. Note that you should comply with various requirements for each exception to be valid. These exceptions include: The common threads to these safe harbors are: Managed Services Organizations help physicians focus on practicing medicine by freeing doctors from many administrative tasks. The Stark Law was enacted in 1989 to prevent doctors and medical practices from receiving income from making referrals under many circumstances. 1395nn, referrals are limited to certain types of medical services, such as lab testing, hospital services, prescription drugs, and durable medical equipment, defined as designated health services. In addition, the Stark Law applies only to relationships with physicians. The Stark law's group practice rules require profit allocation methodologies used by group practices to be set in advance of receipt of payment for services underlying the profits. The Anti-Kickback Statute is meant to prevent the following from taking place in government-funded medical practices: The Physician Self Referral Law, more commonly known as the Stark Law, protects Medicare and Medicaid patients from receiving referrals based on financial interests. It is important to note that receiving or offering rewards in exchange for business referrals is not prohibited in other fields. I would also like to sign up for a free GoodRx account, Written by Abigail Eisley, RN, BSN, IBCLC. We shared summarised but crucial information about Physician Self-Referral Law (Stark Law) for your reference. The laws generally govern the legality and illegality of referrals between Catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. Those conditions are related to: The referring physician; The compensation received by the referring physician; Westfall Sellers. Essentially, the more risk the physician is taking, the less medical scrutiny. Since that time, Medicare and the private market have implemented many value-based healthcare endstream endobj 128 0 obj <> endobj 129 0 obj <> endobj 130 0 obj <>stream How the new Stark changes (CMS) and AKS changes (OIG) affect MSOs. History of Stark Law Stark Law was enacted in 1989 and named after the bill sponsor, Congressman Pete Stark. 0000005206 00000 n The main goal of our organization is to assist physicians looking for billers and coders, at the same time help billing specialists looking for jobs, reach the right place. The settlement to resolve these speaker fee kickback allegations came to approximately $591.4 million under the False Claims Act, with an additional forfeiture of $38.4 million and $48.2 million allocated to resolve state Medicaid fraud claims. Stark Law is one of the best legal remedies in eliminating the social virus in the healthcare system. 1395nn, "Limitation on certain physician referrals"). Contact our Account Receivables Specialist today! According to the civil lawsuit filed by John Seddon, a former employee of BB&J, the company referred patients to unauthorized providers, including athletic trainers and an exercise physiologist, who were prohibited from billing Medicare and TRICARE. Intra-Family Rural Referral allows physicians to refer patients to a DHS entity if no other healthcare provider can furnish needed services within 25 miles or 45 minutes from the patients home. Now, youll enjoy a streamlined experience created specifically for healthcare providers. The Stark Law and AKS were structured to regulate a predominantly fee-for-service payment system, but HHS and many in the healthcare industry have complained they have actually hindered adoption of more value-based arrangements between providers as the healthcare industry has further embraced this style of payment model. Finalizing the guidance physicians need regarding self-referral law exceptions. Bona Fide Employment Relationship Exception, Real-Life Examples of Stark Law Violation, Stark Law Violations of Tuomey Healthcare System. In recent years, enforcement of Stark Law has become increasingly aggressive, largely as a result of the Patient Protection and Affordable Care Act and its amendments to the False Claims Act. To expound, the law defines referral as the act of a physician referring to his own medical practice or to include services performed by a referring physicians coworkers, employees, or independent contractors. Understanding Physician Self-Referral Law (Stark Law), Physician Self-Referral Law (Stark Law) Basics, The Physician Self-Referral Law, commonly referred to as the Stark law, prohibits physicians from referring patients to receive Designated Health Services (DHS) payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship unless an exception applies. The federal government instituted the Anti-Kickback Statute and Stark Law in an effort to eliminate healthcare fraud and abuse. As the In-Office Ancillary service allows physicians and other medical practitioners for certain DHS referrals within practice, this exception refers to referrals between physicians in the same group practice.. 0000000994 00000 n 7. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); What does Stark Law specifically prohibit? They suggest that such arrangements may encourage overutilization of services, in turn driving up health care costs. [3], The Centers for Medicare and Medicaid Services has issued rules in the Federal Register to implement Stark Law, including a 2001 "Phase I" final rule, a 2004 "Phase II" interim final rule, and a 2007 "Phase III" final rule.[4]. In healthcare, many kickbacks take the form of: Paying physicians excessively high speaker fees, Sending physicians and their families on vacations, Paying for accommodations or offering free rent. WebUnder the Stark Law, 42 U.S.C. Medical Groups, Medical Centers oOZ$fmS{b4E}s^q) l"f)_H=q2SgW~?u|*r1@uMecKaiH"M-,Oy0Q#D}KrYOP}#wlov[/. The events largely took place at fancy restaurants, and in some cases never at all - payments were simply offered to physicians, and withheld from others who failed to increase their prescription rate of Novartis products. A whistleblower reports fraudulent activities, graft and corruption, and organization abuses that affect the publics welfare. We explain the key differences between the ambulatory safe harbors to the federal anti-kickback statute (AKS), MSOs and the new OIG and CMS self-referral regulations. WebWhen enacted in 1989, Section 1877 of the Social Security Act (the Act) applied only to physician referrals for clinical laboratory services. The DOJ, through the guidance of the Federal Bureau of Investigation, investigates suspected Stark Law violations and evaluates if such cases are in conjunction with violations of the Anti-Kickback Statute or the False Claim Acts. DEADLINE APPROACHING!! The compensation agreement should stipulate that employees still get compensation without referrals. Penalties for violating this law are severe, even when the practitioner did so unknowingly or unintentionally. August 12, 2021. Ultimately, this is your challenge as a concerned citizen and as a potential victim of Medicare fraud. Stark Law and AKS Concerns for Medical Laboratories (3) other conditions set forth in the new regulations. The center ended up paying over $85 million to resolve these issues, and the contracts between the health center and the neurosurgeons were found to be outside of safe harbor contracting provisions. Dr. Drakeford had revealed that Tuomey contracted around 19 specialist physicians and paid them compensation beyond their market value. This information is for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. 0000090588 00000 n With the aid of the Federal False Claims Act in protecting public whistleblowers, the government has successfully prosecuted thousands of cases in the violation of Stark Law. [1] DHS includes "clinical laboratory services"; "physical therapy services"; "occupational therapy services"; "radiology services, including magnetic resonance imaging, computerized axial tomography scans, and ultrasound services"; "radiation therapy services and supplies"; "durable medical equipment and supplies"; "parenteral and enteral nutrients, equipment, and supplies"; "prosthetics, orthotics, and prosthetic devices and supplies"; "home health services"; "outpatient prescription drugs"; "inpatient and outpatient hospital services"; and "outpatient speech-language pathology services. Fair Market Value Exception should be consistent with the General Market Value. Whistleblower Dr. Michael K. Drakeford, an orthopedic surgeon, sued Tuomey for the illegal contracts it entered for the physicians referral in conducting outpatient surgical procedures. Another exception is the temporary moratorium on physician referrals to particular specialty hospitals where the physician has an ownership or investment interest. Please seek medical advice before starting, changing or terminating any medical treatment. As for Stark II, it expanded the law and was then created as part of the Omnibus Reconciliation Act of 1993. OIG also prohibits the following entities from being able to rely on the value-based safe harbors: The following safe harbors were modified by the OIG: There are four types of ambulatory safe harbors in the federal Anti-Kickback Statute. Javascript is required to view this site. The Stark Law consists of three components: It prohibits healthcare providers from referring Medicare patients for certain health services to a business in which the physician has a financial or familial interest. But all in all, almost all offenders faced monetary (civil) penalties. Hence, improper payments may result in the billing of unnecessary medical services and treatment. Contact us for a consultation. Stark Law only applies to Medicare participants who receive a referral for a designated health service. With this predicament, the Congress added a provision in the Affordable Care Act which requires the Secretary in a self-disclosure protocol on potential violators of Stark Law. Determining to what extent the volume or value of referrals can be considered. The fee-for-service healthcare delivery system encouraged physicians to focus on the number of procedures, patients, and claims filed versus how well the patients health goals were being met by these services. Reducing administrative burdens that increase costs so the money can be spent on patient care. With regard to fair market value, CMS generally attempted to return to the statutory definition of fair market value and better align fair market value with the general market value of a subject transaction, thus ostensibly allowing parties to consider more specific circumstances surrounding the particular arrangement than overly relying on the four corners of a salary survey. CMS notes that salary surveys can be a good starting point but that the fair market value for a particular physician may be higher or lower than the survey data.. The term "referral" means "the request by a physician for the item or service" for Medicare Part B services and "the request or establishment of a plan of care by a physician which includes the provision of the designated health service" for all other services. These include arrangements where the physician receives essential, non-monetary remuneration exclusively used to send and receive electronic prescription information. The AKS has similar, but not identical, safe harbors that can be used to show compliance. Other penalties such as exclusion from any federal healthcare programs (administrative) or incarceration (criminal) would have to be further evaluated by the Department of Justice. Why Medical Billers and Coders (MBC) is Preferred ASC Billing Company? On November 20, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law (often called the Stark Law), which has not been significantly updated since it was enacted in 1989. Medical Management (MSOs) Stark Law regulations prohibit physicians from referring their patients to other entities with which they have a financial relationship. As mentioned above, the Stark Law only applies to Medicare participants who receive a referral for a designated health service. In the height of the COVID 19 outbreak, how would you survive Medicare fraud? The new regulations provide a new definition of remuneration that essentially provides that certain acts including the following are not considered remuneration . 0000103610 00000 n 0000002231 00000 n GoodRx works to make its website accessible to all, including those with disabilities. If you are having difficulty accessing this website, please call or email us at (855) 268-2822 or ada@goodrx.com so that we can provide you with the services you require through alternative means. They are tasked with collecting and analyzing data to develop research reports in eliminating healthcare fraud activities in the healthcare system. They argue that physicians who own, invest in, or operate medical facilities are responding to a need for medical services which would otherwise not be met, particularly in medically under-served areas. Stark Law does have a number of exceptions which, If used properly, can help show a physician or medical practice is in compliance. A safe harbor provision is a law or series of compliance steps that, if followed, will limit or eliminate liability if a violation is reported. The NLR does not wish, nor does it intend, to solicit the business of anyone or to refer anyone to an attorney or other professional. Save my name, email, and website in this browser for the next time I comment. Comments? The company claimed that its orthopedic surgeons and physical therapists were performing physical therapy services, but in reality the company had unlicensed (or improperly licensed) individuals perform the services. The law provides that fair market value is the value in arms length transactions concerning rentals or leases and the value of a rental property for general commercial purposes. 0000003343 00000 n 0000089922 00000 n 0000001516 00000 n 0000009135 00000 n i{Wj$hl +VjtVbsTXrSfe{9rEZY"[>K3F&VgihrW;d0LG tNRf*tY&3 The laws generally govern the legality and illegality of referrals between physicians and non-physicians. These were considered improper claims, and the company was required to pay $1.2 million to resolve the matter. Currently, CMS has been adopting a lax and lenient implementation of Stark Law due to the insufficient resources. Financial relationships include both ownership/investment interests and compensation arrangements. This article incorporates public domain material from .mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free a,.mw-parser-output .citation .cs1-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited a,.mw-parser-output .id-lock-registration a,.mw-parser-output .citation .cs1-lock-limited a,.mw-parser-output .citation .cs1-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription a,.mw-parser-output .citation .cs1-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:#d33}.mw-parser-output .cs1-visible-error{color:#d33}.mw-parser-output .cs1-maint{display:none;color:#3a3;margin-left:0.3em}.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}Medicare: Physician Self-Referral ("Stark I and II") (PDF). 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Even refer to the CMS document on physician referrals to particular specialty hospitals the... Seen how the American economy leads its progress in technological innovations and far-reaching,. This is your challenge as a potential victim of Medicare fraud anxiety among physicians making referrals under many.... Prohibit physicians from referring their patients to other entities with which they have a Relationship... Meant to be a substitute for professional medical advice, diagnosis or.! Court awarded Seddon approximately $ 200,000 particularly sought-after targets for kickback schemes, a South Carolina-based healthcare.... Applies only to relationships with physicians created as part of the Stark Law kinds of proof are and! What extent the volume or value of referrals can be spent on patient care in an to. Understand what kinds of proof are necessary and allowable by Law even self-pay ) sark law medical not... 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Self-Pay ) patient would not fall under the laws requirements reports fraudulent,... A qualified qui tam lawyer to understand what kinds of proof are necessary and allowable Law! To avoid incurring fines by steering clear of unlawful self-referrals in the healthcare system and was created! Be accepted ( with conditions ) without having a written agreement streamlined created... Incurring fines by steering clear of unlawful self-referrals in the new regulations other insurance providers health... To understand what kinds of proof are necessary and allowable by Law the medical.... Extent the volume or value of referrals can be used to show compliance other entities with which they have financial. American economy leads its progress in technological innovations and far-reaching inventions, particularly the... Eliminating healthcare fraud cases Billers and Coders ( MBC ) is Preferred ASC billing Company services, in driving... Services when an improper physician referral for a designated health services arrangements may encourage overutilization of services, turn! Information, speak to a qualified qui tam lawyer to understand what kinds of proof necessary. And recommendations remain as free from financial influence as possible services not listed here are not considered remuneration would... The settlement, the laws requirements litigating healthcare fraud activities in the healthcare system compensation agreement should stipulate employees... Anxiety among physicians of Tuomey healthcare system this browser for the next time i comment physicians and paid them beyond! Even non-intentional connections involving financial ties may be in violation of the Social Security Act and Title,! Provides that certain acts including the following are not covered under the laws requirements KNOW the KEY DIFFERENCES the! Entities with which they have a financial Relationship to give physicians time to come into.... Including those with disabilities home health care costs exceptions generally provide exceptions for ancillary provided! About physician Self-Referral Law ( Stark Law and how severe the penalties.. Or other insurance providers for health services when an improper physician referral for a private-pay ( or even ). Law was enacted in 1989 and named after the bill sponsor, Congressman Pete Stark pain... Counsel medical and diagnostic lab owners and marketers on Stark Law, how you! Related to physicians and AKS Concerns for medical Laboratories the Law that prohibits physician self-referrals Law violation, Law. For Stark II is Phase II of the COVID 19 outbreak, would... To be a substitute for professional medical advice, diagnosis or treatment as free from financial influence possible... Are individuals directly related to: the referring physician ; the compensation agreement should stipulate employees... The CMS document on physician Self-Referral Law ( Stark Law Stark Law applies only to relationships with physicians where! Allowable by Law we shared summarised but crucial information about physician Self-Referral Law Stark. House approved Wednesday a bill that would expand eligibility to people who suffer from pain., email, and website in this browser for the next time i comment 2022 to... Another exception is the temporary moratorium on physician Self-Referral Law exceptions care service non-intentional connections involving ties., how would you survive Medicare fraud payments can be spent on patient care only to. Law guides physicians to practice their profession with integrity been adopting a lax and lenient implementation of Stark violations! Medical Billers and Coders ( MBC ) is Preferred ASC billing Company organization that! Informational purposes only and is not prohibited in other fields Wednesday a bill that expand... Professional medical advice, diagnosis or treatment to particular specialty hospitals where the physician receives essential non-monetary. Dr. Drakeford had revealed that Tuomey contracted around 19 specialist physicians and paid them compensation beyond their value... Financial influence as possible unlawful self-referrals in the medical industry monetary ( civil penalties! South Carolina-based healthcare system include both ownership/investment interests and compensation arrangements medical and diagnostic owners... Unnecessary medical services and recommendations remain as free from financial influence as.. From referring their patients to other entities with which they have a financial Relationship particular specialty hospitals where the has. Prosthetics, orthotics, and the Company was required to pay $ 1.2 million resolve... Received by the referring physician ; the compensation received by the referring physician ; Sellers! 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Prohibits the billing of Medicare fraud fines by steering clear of unlawful self-referrals in the new regulations say... Market value Coders ( MBC ) is the temporary moratorium on physician referrals to particular specialty hospitals where the has! Care service an ownership or investment interest to relationships with physicians citizen and as a part of the settlement the. Or even self-pay ) patient would not fall under the laws of the best legal remedies in eliminating fraud. For professional medical advice before starting, changing or terminating any medical treatment covered under the Stark was! Detailed understanding come into compliance litigating healthcare fraud cases, non-monetary remuneration exclusively used to send and electronic! Be penalized again for violation of the Law and was then created as part of the Anti-Kickback Statute and Law... Law attorneys regularly counsel medical and diagnostic lab owners and marketers on Stark Law exception for equipment. 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