Chapter 5: Key Laws in Healthcare Compliance

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Physician Self-Referral Law (Stark Law)

By Gabriel Imperato,[1] Esq., CHC; Anne Novick Branan,[2] Esq., CHC; Richard Sena[3] ; and Megan Speltz,[4] JD

Fast Facts

Title of law: Limitation on certain physician referrals (commonly called the Stark Law or Physician Self-Referral Law)

Categories:

  • Medicare

  • Medicaid

  • Fraud and abuse

U.S. Code: 42 U.S.C. § 1395nn

Year enacted: 1989

Major amendments:

  • Omnibus Budget Reconciliation Act of 1990 (Stark I)

  • Omnibus Budget Reconciliation Act of 1993 (Stark II)

  • Medicare Program; Modernizing and Clarifying the Physician Self-Referral Regulations, 85 Fed. Reg. 77,492 (December 2, 2020)

Enforcement agencies:

  • U.S. Department of Justice

  • Centers for Medicare & Medicaid Services

  • U.S. Department of Health & Human Services

Link to full text of law: https://www.govinfo.gov/content/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXVIII-partE-sec1395nn.pdf

Applies to: Physician referrals for health services in which the referring physician has some financial relationship with the referred entity.

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