Named for its initial sponsor, Congressman Pete Stark, the Stark Law refers to a provision of the Social Security Act that prohibits physician self-referral for patients with Medicare or Medicaid benefits. Generally speaking, its purpose is to prevent the conflict of interest that may arise from a physician referring a patient to a medical facility in which he or she has a financial interest. Specifically, a physician may not refer a Medicare or Medicaid patient for any designated health service to a facility in which he or she (or an immediate family member) has a financial interest or relationship.

If you have knowledge of a physician or billing entity that has violated the Stark Law, call the attorneys of Belt Law Firm at 888-933-1514 for a free confidential consultation.

The Stark Law was originally enacted in 1989 and focused specifically on physician referrals for clinical laboratory services. In 1993, it was expanded to a much broader range of medical services. Today, the following are considered “designated health services” under Stark:

• Clinical laboratory services
• Physical therapy, occupational therapy, and speech language pathology services
• Radiology and certain other imaging services
• Radiation therapy services and supplies
• Durable medical equipment and supplies
• Parenteral and enteral nutrients, equipment, and supplies
• Prosthetics, orthotics, and prosthetic devices and supplies
• Home health services
• Outpatient prescription drugs
• Inpatient and outpatient hospital services
• Nuclear medicine

Other arrangements that may run afoul of the Stark Law include:

• Space and equipment leases
• Marketing agreements
• Below fair market value agreement between providers and suppliers
• Waivers of co-payments and deductibles
• Office sharing agreements and time-sharing arrangements

The financial interest or financial relationship outlined in Stark typically falls into two categories. The relationship may be a direct or indirect "ownership or investment interest" in the facility or a "compensation arrangement" between the physician and the facility. Because it is so broad and has so few exceptions, the Stark Law is considered to be one of the most far-reaching anti-fraud tools employed by the federal government. It is important to note that a physician may be in violation of Stark without knowing it; physicians have the responsibility of making certain they are in compliance.

Stark and Whistleblowers

In legal terms, the provisions of the Stark Law intertwine with the False Claims Act or the Anti-Kickback Law. Individuals who are aware of fraudulent activity in violation of the Stark Law may file a lawsuit in the name of the U.S. Government. When such a suit is successful, the Federal Civil False Claims Act provides for financial compensation for the party that filed and pursued the suit, typically between 15 percent and 30 percent of the monies recovered.

Belt Law Firm, P.C. would be interested in speaking with you if you have knowledge of any such activities that would violate these laws. Individuals who are aware of illegal activity should seek knowledgeable legal counsel who will protect their rights and represent their interests.

For your free Stark law consultation with a Stark Law Attorney, fill out our contact form or call us at 888-933-1514 (toll free).