What is Stark Law? Stark Law, also known as the Physician Self-Referral Law, is where if a physician is related to another health care provider, they cannot recommend a Medicare or Medicaid patient to them and doing this would be known as a self-referral.
Origins of Stark Law
Stark Law originated from Californian Congressman Fortney “Pete” Stark; it was added as an amendment to the Social Security Act. However, are a few exceptions: one of which was finalized in 2021 and stated that arrangements can be made where if the health care provider pays compensation (of under $5,000) to the physician in exchange for the items provided and thus would not be blocked by the Stark Law.
In summary, a physician or direct family member is not allowed to send a Medicare or Medicaid patient to another individual if they have any financial ties with them.
Image Credit: Ezequiel_Octaviano
Works Cited:
Inc, US Legal. “History of Stark Law – Stark Laws.” Starklaws.uslegal.com, starklaws.uslegal.com/history-of-stark-law/. Accessed 8 January 2024.
U.S. Department of Health and Human Services. “Fraud & Abuse Laws.” Office of Inspector General | Government Oversight | U.S. Department of Health and Human Services, 2021, oig.hhs.gov/compliance/physician-education/fraud-abuse-laws/. Accessed 8 January 2024.
Excellent summary