The Stark Law Violation or Not
Answer: The Stark Law Violation or Not
The Stark Regulation is a “strict liability” law, which means that a party’s intent to promote referrals is not needed for the law to be violated. A Stark Law violation can result from an agreement that does not really affect physician referrals, where the parties were unaware or should have been aware that the claims were in violation of the Stark Law, and includes medically essential services.
Unless an exception applies, the Stark Law prohibits:
- a physician from referring certain designated health services (“DHS”) payable by Medicare to an entity with which he or she (or an immediate family member) has a financial relationship, and
- the entity receiving the referral from submitting claims to Medicare for those referred services.
- Because a physician’s practice is a DHS entity when it provides DHS, the referral ban applies to referrals inside a physician’s own practice and may include internal referrals from a practicing physician to their OEC if the referral is for DHS.
HCA 322 Week 4 Assignment, The Stark Law Violation or Not