Understanding physician arrangements and Stark law is critical to ensure patient care while complying with legal policy, according to an Oct. 4 article published in JDSupra and written by the Health Care Compliance Association.
Here are five notes to know:
1. Adhering to Stark law is important because it is a strict liability statute that does not require proof of intent to violate the law, the article said.
2. Stark law prohibits physicians from making referrals for certain Medicare-payable health services if the physician or immediate family member has a financial relationship with the entity.
3. These services include lab services, physical, occupational and speech therapy, durable medical equipment, prosthetics, radiology, home health, pharmaceuticals and inpatient and outpatient services.
4. It is important to consider Stark law's "commercially reasonable" compensation stipulations, according to the article. Determining what is considered reasonable is relatively subjective, and it must be "fair and reasonable in relation to the services they provide" while accounting for physicians' qualifications, experience and market rates.
5. Stark law prohibits compensation arrangements based on volume or referral value to put patient care as a top priority.