Antikickback/Stark Law
Fraud Waste and Abuse Training Requirements Eliminated for Providers
A final rule published in the April 15, 2010 Federal Register makes clear that enrolling in Medicare is considered enough proof that providers know about fraud, waste and abuse issues, and that Medicare Advantage (“MA”) plans do not need to require additional compliance training. In the 2007 MA regulations, CMS stated that it would hold… Read More »
Stricter Self-Referral Rules Under Stark May Bring an End to Some Physician-Hospital Contracts
Major changes to the federal anti-self-referral rules known as the Stark law take effect October 1, 2009. These changes were approved over a year ago, and could potentially cause many physician-hospital arrangements to fall out of compliance if doctors are not prepared. Lack of knowledge of the Stark law revisions or the structure of a… Read More »
How to Avoid Stark Issues When Choosing Service Providers
According to a new Department of Health and Human Services report, in 2005, those doctors who ordered the most magnetic resonance imaging (“MRI”) services for their patients were more prone to have a medical practice or other form of business relationship with the provider performing the service. The analysis of physicians reimbursed by Medicare for… Read More »
CMS Modifies Stark, Again: Implications Abound for Physicians
The Center for Medicare and Medicaid Services (“CMS”) recently released updates of its third phase of final regulations to the federal physician self-referral law (the “Stark Law”). The third phase of final regulations is appropriately titled “Stark III.” Stark III clarifies, and in some cases substantially revises, various concepts, definitions, and exceptions to the… Read More »
The Stark Law and Federal Anti-Kickback Laws: What You Need to Know
The Stark Act is an amendment to the Social Security Act prohibiting physicians from engaging in a “self referral” when referring patients elsewhere for certain services. Stark prohibits physicians from referring their patients to other entities for designated health services (“DHS”) payable by Medicare when the physician or an immediate family member of the physician… Read More »
Group Practice DHS Revenue Allocation under the Stark Law
The latest phase of the Stark Law, known as Stark III, does not alter the basic premise that a group practice can pay a physician a share of overall profits or a productivity bonus provided that such share or bonus is not based on the volume or value of Designated Health Services (DHS) referrals by… Read More »
