Stark Law Definition

Learn about Stark Law, a regulation that prevents healthcare providers from making referrals for financial gain. Discover key components, examples of violations, case studies, and enforcement statistics.

What is Stark Law?

Stark Law, also known as the physician self-referral law, is a complex set of regulations that aim to prevent healthcare providers from making referrals based on financial gain rather than the best interests of the patient. It prohibits physicians from referring patients to entities with which they have a financial relationship for designated health services (DHS).

Key Components of Stark Law

  • Prohibition on physician self-referrals
  • Prohibition on billing for services resulting from prohibited referrals
  • Exceptions for certain arrangements

Examples of Stark Law Violations

One common example of a Stark Law violation is a physician referring patients to a laboratory in which they have a financial interest. This type of arrangement could lead to unnecessary testing and increased healthcare costs.

Case Studies

In 2018, a hospital in Texas settled a Stark Law violation case for $3 million. The hospital was found to have had improper financial relationships with physicians, resulting in overpayment for services.

Statistics on Stark Law Enforcement

According to the Department of Justice, Stark Law enforcement actions have resulted in over $700 million in settlements since 2009. The government continues to prioritize the enforcement of these regulations to ensure the integrity of the healthcare system.

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