HLT 520 Week 4 Discussion 1 Latest-GCU

Discuss your opinion of the Stark laws, what they are designed to do, the impact of the exceptions, and whether you think they are successful in preventing unethical behavior.

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The Stark laws

Introduction

The Stark laws are a set of federal laws that regulate the relationship between doctors and their patients in the United States. These laws were put into place by Congress in order to protect Medicare patients from being overbilled or abused by hospitals and other healthcare providers.

Stark Law 1, a.k.a. the “Physician Self-Referral Prohibition”

Stark Law 1, also known as “Physician Self-Referral Prohibition”, is a federal law that prohibits health care providers from referring their own patients to other physicians for services. In other words: no one at your local doctor’s office can refer you over to another practice.

The Stark Law does not apply to physicians who are not Medicare providers (like eye surgeons or dermatologists).

Stark Law 2, a.k.a. the “Limitation on Payments for Referrals”

Stark Law 2, a.k.a. the “Limitation on Payments for Referrals” (also known as the “Stark Law”) prohibits a physician from referring a patient to a health care facility in which the physician or an immediate family member has a financial interest. The law does not prohibit physicians from referring patients to facilities in which they have no financial interest—but it does require that they disclose this fact when making such referrals.

The Stark laws have been shown to be difficult to comply with as well as expensive if not properly structured by skilled counsel

The Stark laws are complex, difficult to comply with and can be expensive if not properly structured by skilled counsel.

The Stark laws were enacted in 1938 as part of the Social Security Act. They prohibit physicians from receiving kickbacks or referrals for medical services from any source other than the government or its contractors which includes Medicare and Medicaid. This prohibition extends to any entity that is related indirectly (e.g., controlled by) or directly (e.g., owned) by a physician who accepts an arrangement involving payment for referrals between doctors and health care providers; receives money for referring patients; charges fees for providing information about its products or services; engages in marketing activities related to its product line such as direct mailings; has one part owner or significant shareholder who also owns another entity that engages in these types of activities

Conclusion

Our experience with the Stark laws has been generally positive and we have found them to be an excellent tool for ensuring patient safety. We hope that this blog post has provided you with some insight into how they can be used in your practice area as well. If you have any questions about Stark Law compliance or would like us to speak on a specific topic, please contact us at [email protected].

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