Just to recap, the Stark Law, also known as the Physician Self-Referral Law, establishes guidelines to ensure physicians practice their profession lawfully, specifically prohibiting self-referral for certain designated health services (DHS). The law aims to prevent physicians from prioritizing personal financial gain over patient welfare.
A single Stark Law violation can result in serious consequences, including civil penalties of up to $15,000 per violation and possible exclusion from Medicare, Medicaid, and other state healthcare programs. Consulting with an attorney who specializes in Stark Law can help ensure that your practice complies with these complicated legal and ethical healthcare requirements.
The focus of Stark Law is to prevent fraudulent practices and conflicts of interest by prohibiting physicians from making referrals for DHS that are payable by Medicare or Medicaid.
Below are notable Stark Law cases from 2024 — examples of what not to do in the healthcare industry.
A Houston doctor faced allegations of submitting false and medically unnecessary claims to Medicare and Medicaid. This unethical and corrupt practice is a direct violation of the Stark Law, as the doctor’s clinical judgment was clouded by financial incentives.
The U.S. government alleges that Erlanger, a healthcare system operating in Tennessee and North Carolina, violated the Stark Law by overpaying physicians, resulting in improper referrals. Despite knowing these referrals were ineligible for Medicare reimbursement, Erlanger allegedly submitted claims for the services. Seeking profit through improper financial relationships is against the law.
Various home health providers in Texas, Ohio, and Indiana violated the False Claims Act by offering illegal kickbacks to assisted living facilities and doctors in exchange for Medicare referrals. This bribery violates the Anti-Kickback Statute, which bans financial transactions that reward referrals for products and services reimbursed by government healthcare programs.
The United States alleged that Penn Highlands DuBois violated the Stark Law by paying physicians improper compensation. The payments were supposedly for services under an agreement that had not yet taken effect, and during this period, neither physician was actually employed by the hospital.
Fenton Jurkowitz Law Group has a team of seasoned Stark Law attorneys who are well-versed in California law, including the Stark Law and anti-kickback statutes. It is important to have legal counsel on your side to ensure you and your healthcare practice are protected. Fill out our contact form on our website today to connect with a Stark Law attorney.