The Physician Self-Referral Law, commonly known as the Stark Law, and the Anti-Kickback Statutes are two federal laws that protect whistleblowers and prohibit a wide range of conduct by healthcare providers.
Who does the Stark Law protect?
The Stark law prohibits a physician’s referral for certain designated healthcare services (DHS) to an entity if the physician (or a member of the physician’s immediate family) has a financial relationship with the entity, unless the referral is protected by one or more exceptions provided in the law.
Does Stark Law protect reporters from retaliation?
Stark law violations are a major source of qui tam cases filed by whistleblowers under the False Claims Act. … As they exist today, the Stark Law prohibits physicians from receiving a financial benefit for ordering, referring, or performing certain types of Designated Health Services (“DHS”).
What is the main intent of Stark laws?
What is the main intent of the Stark laws? Prohibit self-referral by physicians to facilities in which they have an ownership interest.
What is an example of Stark Law?
For example, if you invest in an imaging center, the Stark law requires the resulting financial relationship to fit within an exception or you may not refer patients to the facility and the entity may not bill for the referred imaging services.
Does Stark Law only apply to physicians?
KEY POINTS. The Stark statute applies only to physicians who refer Medicare and Medicaid patients for designated health services to entities with which they (or an immediate family member) have a financial relationship. There are almost 20 exceptions to the Stark statute.
What does Stark Law prohibit?
The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from making referrals to an entity for certain healthcare services, if the physician has a financial relationship with the entity.
Are whistleblowers protected from retaliation?
Whistleblowers perform an important service for the public and the Department of Justice (DOJ) when they report evidence of wrongdoing. All DOJ employees, contractors, subcontractors, grantees, subgrantees, and personal services contractors are protected from retaliation for making a protected disclosure.
Is there a law against retaliation?
Is Retaliation Always Illegal? It’s not. Retaliation is only illegal when the action that precedes the retaliation is protected by law. … It’s always illegal to retaliate against an employee for actions such as sexual harassment, racial discrimination, and concerted workplace activities.
What is the difference between Stark and Anti-Kickback?
Source of Prohibited Referrals: Whereas the Stark Law only pertains to referrals from physicians, the Anti-Kickback Statute applies to referrals from anyone. … The Anti-Kickback Statute provides for criminal punishment in addition to civil sanctions.
What is considered an illegal provider relationship?
Which of the following is considered to be an illegal provider relationship? Any person or entity who knows, or should have known, of the presentation of a false or fraudulent claim to the government for payment or approval is subject to . At a minimum, documentation must .
What is the Stark II law?
Stark II prohibits a physician or immediate family member who has a direct or indirect financial relationship with an entity from making referrals to that entity to provide designated health services (DHS) payable by Medicare or Medicaid, unless an exception applies.
How does Stark Law affect patients?
This statute prevents fraudulent and unnecessary testing, referrals, and medical services. Additionally, it prevents physicians from seeking further personal financial or equity gains regarding patient care which is a clear conflict of interest. These limitations impact clinical decision-making and healthcare delivery.
What are the penalties for violating the Stark Law?
What are the penalties for violating Stark? Penalties for violating Stark can be severe. They include denial of payment, refund of payment, imposition of a $15,000 per service civil monetary penalty and imposition of a $100,000 civil monetary penalty for each arrangement considered to be a circumvention scheme.