Stark Law
Stark Law
Lesley-Ann Herard
HCA 322 Jeff Kingsbury May 4, 2015
Stark Law was put in place to prevent physicians or groups from taking advantage of self- referrals. "It is a federal statute whose purpose is to, in essence, limit conflicts of interest in situations where physicians have financial relationships that could cause them to steer referrals for patients to certain providers or potentially over utilize services based on their financial relationships,"(Sandrick 2008). For this paper I will analyze if the two physicians violated Stark Law by their actions.
Dr. S and Dr. V were trying to beat the system by cutting out the middle man. They thought if we have the machine then we no longer have to outsource our patients to the local hospital. But they never considered how this would affect the hospital that depends on the revenue of the nuclear camera. As we know hospitals are always over budget and under staffed. For the hospital to lose money would make it harder for them to improve other things that need to be taken care of in the hospital. Granted the hospital did come to an agreement with the two physicians, it caused conflict with other physicians who saw this is an Anti-Kickback and Stark Acts. They believed that they were putting in false claims in to bill Medicare. “Escalating health care expenditures pose a variety of ethical and legal challenges when they are the result of legitimate services, but especially when they are the product of fraudulent or abusive conduct by providers. Thus, it is a social imperative to contain those escalating costs so that finite resources can be used more efficiently and equitably.” (Bustillos 2013) Granted there is not much information on how the other physicians knew that Dr. S and Dr. V were falsifing information. I would need proof to determine if they did violate the law. “"Historically, a hospital would get in trouble under Stark only if someone
Lesley-Ann Herard
HCA 322 Jeff Kingsbury May 4, 2015
Stark Law was put in place to prevent physicians or groups from taking advantage of self- referrals. "It is a federal statute whose purpose is to, in essence, limit conflicts of interest in situations where physicians have financial relationships that could cause them to steer referrals for patients to certain providers or potentially over utilize services based on their financial relationships,"(Sandrick 2008). For this paper I will analyze if the two physicians violated Stark Law by their actions.
Dr. S and Dr. V were trying to beat the system by cutting out the middle man. They thought if we have the machine then we no longer have to outsource our patients to the local hospital. But they never considered how this would affect the hospital that depends on the revenue of the nuclear camera. As we know hospitals are always over budget and under staffed. For the hospital to lose money would make it harder for them to improve other things that need to be taken care of in the hospital. Granted the hospital did come to an agreement with the two physicians, it caused conflict with other physicians who saw this is an Anti-Kickback and Stark Acts. They believed that they were putting in false claims in to bill Medicare. “Escalating health care expenditures pose a variety of ethical and legal challenges when they are the result of legitimate services, but especially when they are the product of fraudulent or abusive conduct by providers. Thus, it is a social imperative to contain those escalating costs so that finite resources can be used more efficiently and equitably.” (Bustillos 2013) Granted there is not much information on how the other physicians knew that Dr. S and Dr. V were falsifing information. I would need proof to determine if they did violate the law. “"Historically, a hospital would get in trouble under Stark only if someone