Quick Answer: Does Stark Law Apply To Pharmacies?

Do Stark laws apply to employed physicians?

Both the Stark Law and the Anti-Kickback Statute contemplate employment of physicians by hospitals, and accordingly, both include an exception to accommodate the compensation paid by a hospital employer to a physician employee..

What is a safe harbor under the Stark Act?

Proposed Stark Law Safe Harbors VBAs in which the VBE assumes full financial responsibility for the cost of all patient care items and services; VBAs in which a physician faces “meaningful,” but not full, financial risk; … Arrangements that involve the donation of cybersecurity technology and services.

What situation is a written agreement not required under Stark?

For example, the following exceptions to the Stark Law require a written, signed agreement: office space and equipment rental, personal service arrangements, physician recruitment arrangements, group practice arrangements, and fair market value compensation arrangements. 42 C.F.R. 411.357.

What is the Stark II law?

Stark II prohibits a physician or immediate family member who has a direct or indirect financial relationship with an entity from making referrals to that entity to provide designated health services (DHS) payable by Medicare or Medicaid, unless an exception applies.

Who does Stark Law apply to?

The Stark statute applies only to physicians who refer Medicare and Medicaid patients for designated health services to entities with which they (or an immediate family member) have a financial relationship. There are almost 20 exceptions to the Stark statute.

What is an example of the Anti Kickback Statute?

Classic examples of violations of Anti-kickback and Stark laws include: … Drug companies paying kickbacks to insurers to get on their formularies; Payments by specialty pharmacies, DME suppliers, therapy centers, nursing homes, etc. to patient recruiters or to patients directly.

Does Stark law protect whistleblowers?

Stark law violations are a major source of qui tam cases filed by whistleblowers under the False Claims Act. … As they exist today, the Stark Law prohibits physicians from receiving a financial benefit for ordering, referring, or performing certain types of Designated Health Services (“DHS”).

Does Anti Kickback Statute apply to private insurance?

In October of 2018 Congress enacted a new law that applies to many commercial health insurance plans, as well as Medicare and Medicaid. Unfortunately, these provisions create expansive anti-kickback penalties for all private and commercial pay business. …

What are the exceptions to the Stark law?

Vaccines, immunizations, and screening tests are generally allowable Stark exceptions provided they aren’t given too often. The tests must be covered by Medicare. Intra-family rural referrals. Additionally, some referrals in rural areas are allowed if the services are for an immediate family member.

What is prohibited by the Anti Kickback Statute?

The AKS is a criminal law that prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients).

Does Stark law apply to chiropractors?

The Stark Law applies to physicians but the Social Security Act defines a physician as a dentist, MD, DO, optometrist, and a chiropractor. … Under the Stark Law, an entity is broadly defined and includes an organization that bills the Medicare Program or performs a DHS.

Does the Stark law apply to hospice?

The Stark law does not apply to the Medicare Hospice Benefit. However, as more hospices begin to provide “non-hospice” palliative care, the Stark issue must be squarely addressed.

Can doctors recommend a pharmacy?

Can a physician own, or own interest in, a pharmacy? Yes. However, there must be no conflict of interest.

Does Stark law apply to private insurance?

The Stark Law, 42 USC § 1395nn, only applies to Medicare and Medicaid. The AKS, 42 USC § 1320a-7b(b)),applies to any federal healthcare program. This is because the Stark Law statute and the AKS were enacted at different times and are worded differently.

What is the difference between the Stark Law and the Anti Kickback Statute?

The AKS prohibits referrals for any kind of item or service where a kickback is involved, while the Stark Law prohibits only the referral of designated health services where a financial interest is involved.