Stark Law Violations
Pennsylvania Health Care Lawyers for Stark Law Violations
The Stark Law [CITATION] is a federal statute that prohibits a physician from referring their Medicare patients for services (such as diagnostic testing and blood work) to a place in which the physician, his/her medical practice, or an immediate family member has an existing financial relationship. The physician or health services entity may not submit claims to Medicare for reimbursement for those services resulting from a prohibited referral. Unlike other anti-kickback statutes, the Stark Law only applies to referrals from physicians, not other medical care providers. By avoiding financial incentives to order more services than necessary, the Stark Law seeks to avoid an over-utilization of medical services by physicians.
Designated Health Services
Under the Stark Law, physicians can not refer “designated health services” (“DHS”) to entities with which they or their immediate family members have a financial relationship. These designated medical services include:
Stark Law Exceptions
Federal law allows certain Medicare referrals even when an existing financial relationship between the referring physician and the medical services provider exists. The mandatory exceptions to the ban on self-referrals include certain written agreements which include:
Violations of the Stark Law can result in criminal sentences including imprisonment, an obligation to repay Medicare funds imposition of civil penalties of $15,000 per service, and civil penalties of $100,000 for each prohibited arrangement. Physicians may be required to repay and reimburse Medicare for all payments received from their referrals during the period of non-compliance and civil assessments may be imposed for up to three times the amount claimed.
Pennsylvania Health Care Lawyers Represent Physicians Concerned About Stark Law Violations
The experienced Pennsylvania health care lawyers at Michelman & Bricker, P.C. assist health care law practitioners with all their business and litigation needs including the counseling and defense against Stark Law claims. Our dedicated Philadelphia health care lawyers help medical providers work proactively to ensure compliance with all federal Medicare and Medicaid regulations, including Stark Law requirements and health care licensing issues. In addition to providing extensive regulatory analysis and strategic business planning advice, contract drafting and employment-related matters, our Philadelphia health care lawyers bring their white-collar criminal defense experience to handling all of your health care-related litigation needs.