As the recent Covid-19 pandemic has come to an end, at least in the eyes of the government, waivers are being rolled back and federal authorities intend to return to the regularly scheduled programming of Stark Law enforcement. With this news in mind, practices should evaluate their operations and conduct internal audits to ensure their own compliance with Stark Law, Anti- Kickback statute, False Claims Act, and others.
Central to any physician-patient relationship is an element of trust — an assurance that a physician’s guidance is purely motivated by the patient’s welfare and devoid of any personal financial incentives. Stark Law, a criminal statute, acts as a shield for this trust, prescribing regulations for physician referrals for designated health services.
The focus of Stark Law is to ensure referrals are determined by the patient’s needs, not by prospective financial benefits. By adhering to Stark Law, healthcare professionals gain the patient’s confidence in their medical counsel, preventing Stark Law violation examples from arising.
A lapse in Stark Law compliance can trigger severe legal and financial repercussions. Violations can lead to considerable fines, the threat of exclusion from federal healthcare programs, and potential criminal charges. These consequences stress the importance of abiding by Stark Law, which many a Stark Law attorney would confirm.
Preserving a physician’s professional standing is yet another critical aspect of Stark Law compliance. Non-compliance allegations can provoke scrutiny from both the medical fraternity and the public, tarnishing the professional image of the physician or practice implicated, and diminishing the trust that patients place in their healthcare providers.
A rigorous monitoring and documentation of all financial relationships between physicians (or their immediate family members) and entities providing designated health services are crucial components of Stark Law compliance. All such relationships, whether overt or covert, must be transparently reported and meticulously documented. Regular checks and audits can help ensure that no non-compliant financial ties go unnoticed.
A key part of Stark Law compliance involves an in-depth understanding of what comprises “designated health services.” This term includes a broad spectrum of medical services, ranging from inpatient and outpatient hospital services to specific prescription drugs, physical therapy, and radiology services. Organizing regular training sessions and updates about any legal alterations in the definition of designated health services can keep the medical staff informed and compliant, providing practical stark law examples.
Stark Law lays down strict regulations on referrals for designated health services to entities with which physicians have financial ties. To maintain ongoing compliance, healthcare practices must implement robust systems to track, monitor, and flag such referrals. Regular audits of referral patterns can serve as an effective method of ensuring continued compliance, keeping any exceptions to the stark law in check.
Stark Law dictates that compensation arrangements must not be influenced by the volume or value of referrals or other business generated, an area often handled by a Stark law attorney. It is, therefore, critical for healthcare practices to meticulously structure these arrangements and conduct regular reviews.
Compliance also encapsulates a medical practice’s billing procedures. It is vital to verify that claims arising from prohibited referrals are not submitted to Medicare or Medicaid. Regular audits, with a special emphasis on denied claims, can help spot and rectify any potential issues in this sector. Contracts with physicians and other healthcare entities should be regularly reviewed and updated to ensure compliance with Stark Law.
Legal counsel can play an instrumental role in reviewing and drafting these contracts, making certain that they do not incentivize prohibited referrals and that compensation terms are in line with fair market value and commercial reasonableness standards.
Taking proactive steps such as regular internal audits can prove effective in identifying and addressing potential compliance issues. These audits should encompass all areas of Stark Law compliance, and the frequency and scope of these audits can be adjusted based on the size and complexity of the practice.
Stark Law and other related statutes are complex and require careful interpretation. In order to avoid penalties that may damage the reputation of your practice, it is advisable to seek representation from a seasoned Stark Law lawyer.
Whether you are currently in need of legal defense or are seeking a precautionary plan, the Fenton Law Group can help with next steps. For more information on how your organization can benefit from hiring a Stark Law attorney, fill out our online contact form today.