Section 1877 of the Social Security Act, also known as the “Stark Law” (42 U.S.C. § 1395nn), has been expanded and amended on several occasions by Congress since its original enactment in 1989. The provision prohibits physicians from issuing referrals for certain “designated health services” (DHS) payable by Medicare to any entity with which the physician, or an immediate family member, shares a financial relationship. Although written with the best of intentions – to lessen the likelihood of self-referrals which might enrich physicians at the expense of patient health – critics say Stark Law could have the opposite effect, at least in some circumstances.
To that end, the journal Radiology recently revealed findings that some brands of gadolinium-based contrast agents (GBCAs) leave traces of heavy metal in the brains of patients who have received an enhanced MRI. Significantly, the studies showed that gadolinium accumulation can occur in all patients, regardless of their diagnosis or underlying medical condition. A paramagnetic metal ion, gadolinium is known to be toxic and may cause severe allergic reactions, blood clots and facial swelling in healthy individuals. For patients with renal dysfunction, the presence of gadolinium can be even more damaging, resulting in the life threatening condition Nephrogenic Systemic Fibrosis.
Radiologists are uniquely poised to spot the potential for such problems when an enhanced MRI has been ordered because of their expertise in administering GBCAs. The Stark Law may inadvertently deter those same radiologists from acting on their suspicions, however. Because radiologists usually have no input regarding the diagnostic test to be performed, or in the contrast agents to be used, they may refrain from altering a referring physician’s order so as to comply with the Stark Law.
New Jersey Health Care Lawyers at Michelman & Bricker, P.C. Advise Physicians on Stark Law Compliance
Medical providers are understandably concerned about Stark Law violations, which carry penalties ranging from stiff monetary fines to criminal charges and even imprisonment. New Jersey Stark Law lawyers at Michelman & Bricker, P.C. have a proven track record of not only counseling physicians on how to stay within the parameters of the law, but also in defending Stark Law claims once they have been made. Submit an online inquiry form or call (215) 557-9440 today to schedule your free, confidential consultation with one of our New Jersey health care lawyers. At our offices in Philadelphia, PA, Longmeadow, MA and Cherry Hill, NJ, we proudly serve clients throughout the surrounding areas.