The Stark Law Violation or Not

The Stark Law Violation or Not

The Stark Regulation is a “strict liability” law, which means it can be broken even if no one intends to promote referrals. A Stark Law violation could result from an arrangement that does not really change physician referrals, where the parties were oblivious or should have been aware that the claims were in violation of the Stark Law, and involves medically necessary services.

Unless an exception applies, the Stark Law prohibits:

Certain Medicare-covered designated health services (“DHS”) cannot be directed to an entity with which the physician (or an immediate family member) has a financial relationship, and the business receiving the referral cannot submit claims to Medicare for the requested services.
Because a physician’s practice is a DHS company when it delivers DHS, the referral ban may encompass internal referrals from a practicing physician to their OEC if the referral is for DHS.