Stark Law and ‘Self-Referral’: A Primer

The Stark Law was originally implemented in the 1990s and among its provisions it prohibited physicians from “self-referring” Medicare patients. However, there is an exception in this law that allow doctors to legally continue the practice of self-referring without the threat of fines or other penalties.

Under the exception known as “in-office ancillary services,” a doctor has the right to refer a Medicare patient to another doctor who is a member of the same practice group as long as the treatment is conducted in the same building or in a centralized building. This protects physicians from facing Stark violations for simply referring patients to other doctors within their coordinated patient care center. For instance, a patient may be referred in-house for radiation therapy for which a doctor with an ownership interest in the practice may garner financial gain.

Exceptions to the Stark Law are not without their detractors. The American Society for Radiation Oncology and the College of American Pathologists have asserted that the loophole creates an environment in which radiation and pathology services are overused by doctors. Last year a bill came to the House that would exclude imagine, pathology, physical therapy and radiation from the exception, but it did not pass. Congressman Pete Stark, who originally wrote and championed the law, said he would not vote for the law today.

To find out if your practice is in compliance with Stark Law referring provisions, meet with the experienced health law attorneys at Buttaci Leardi & Werner, LLC in New Jersey, New York, and Pennsylvania.

Tagged with: self-referring, Stark Law

• Posted on: Feb 19 2015