Stark Law Statute Explained by Medical Practice Attorney
Stark law is applicable to any dentist, physician, and/or medical practice that accepts Medicare and Medicaid patients. It prohibits dentists and physicians (the definition of which includes chiropractors) from referring patients to any facility where the practitioner and/or their immediate family own, are invested, or have an interest, for certain “Designated Health Services” (“DHS”).
In addition to the penalties for the referring dentist or doctor, Stark law also prohibits the referred facility to bill for services rendered for such DHS. If you are dentist or doctor who owns a private practice and plan on investing in other medical facilities you should consult with a medical practice attorney to understands the prohibitions and safe harbors of Stark Law so you do not run afoul of it.
There are certain services that do not trigger Stark law, and there are also exemptions and exceptions that may be applicable under certain circumstances.
Designated Health Services (DHS) Under Stark Law.
The following is a list of some of the DHS that are regulated under Stark Law:
Clinical laboratory services
Physical therapy services
Speech-language pathology services
Radiology, radiation therapy services
Durable medical equipment and supplies
Occupational therapy services
Parenteral and enteral nutrients, equipment and supplies
Prosthetics, orthotics and prosthetic devices and supplies
Home health services
Inpatient and outpatient hospital services
Outpatient prescription drugs
Penalties under Stark Law.
Denial of claim: must refund any payment
Civil monetary penalty: $15,000 per claim, possible triple damages
Failure to report: $10,000 per day
Exclusion from Medicare and Medicaid programs
Civil law, strict liability with no “intent” requirement
Excluded from Federal Health Programs.
With a wave of relatively new federal and state statutes that regulate the dental and medical industry as well as the entire medical industry being in the spotlight from the law enforcement perspective, it is imperative that you, your practice, and your contracts are in compliance with these rules and regulations and that you are properly represented by an attorney that is experienced in this field of law.
Our medical practice lawyers offer legal representation in the following commercial healthcare transactions:
Buying or Selling Medical and Dental Practices
“Partnership” and Buy Into Medical and Dental Practices
Start-Up of Medical and Dental Practices
Buying or Leasing Office Space for Medical and Dental Practices
Associate Employment Contracts for Dentists and Physicians
Litigation of Commercial Disputes Including
Breaches of Contract and Partnership Lawsuits
Kamkari Healthcare Law