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What is the Physician Self-Referral Law (42 U.S.C. § 1395nn) - “The Stark Law”

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What is the Physician Self-Referral Law (42 U.S.C. § 1395nn) - “The Stark Law”

The Physician Self-Referral Law is commonly referred to as the (Pete) “Stark law”.  It prohibits physicians from referring patients to receive "designated health services" payable by Medicare or Medicaid. When you see a term such as Medicare fraud attorney it often refers to allegations of Stark violations but not necessarily. The Code of Federal Regulations has a myriad of rules that a practitioner, hospital or medical practice can violate. Generally the violations result in a compensation dispute but at times there is Stark law spillover. Stark law violations are limited to “designated health services” and the referral has to be from entities with which the physician or an immediate family member has a financial relationship.  And then there are many exceptions.

See AMA Summary of the Stark Law

See CMS Summary of the Stark Law

See OIG Summary of Stark & Other Healthcare Fraud Laws

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