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This 3 page paper provides an overview of physician self-referral and the Stark I and II laws. Bibliography lists 1 source.
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3 pages (~225 words per page)
File: MH11_MHStark.rtf
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Unformatted sample text from the term paper:
and health care service providers. Essentially, this law is designed to prevent physicians from receiving compensation from specific designated health services (DHS) who are reimbursed by Medicare or Medicaid
from providing compensation for referrals (AAMC, 2004). Specifically, the law requires protection from these kind of compensatory relationships between physicians and DHSs, which include radiology providers, occupational therapists, physical
therapists, clinical laboratories, and other service or medical supply providers (including outpatient prescription drug services) (AAMC, 2004). In addition, relationships where physician investment defines this kind of relationship was
also determined as a measure of the Stark law, with a focus on attempts to separate physician actions with compensatory measures from outside influences. Though exceptions were made in
regards to the involvement of physicians and referring research hospitals, including academic hospitals (teaching hospitals), the regulation provided distinct limits on the actions of referring physicians when monetary gains can
be perceived. There are a number of types of relationships that can violate the Stark law. For example, if a physician is a business partner with a pharmaceutical
company providing outpatient prescription drugs, the physicians referral to this company would be prohibited under Stark law. Under Stark I, physicians receiving compensation through Medicaid or Medicare who had
referrals directed towards certain facilities owned or operated by a physician or their family member might also be prevented, even if there was a connection with a teaching facility.
Under Stark II, slightly different regulations apply to teaching facilities, but there are requirements regarding the nature of the institution, the determination that it is a bona fide teaching facility
and specific limitations in terms of research conducted. One of the defining characteristics under Stark I is the fact that designated health services which are receiving a physician
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