Stark law

Introduction

 In broad perspective, spark law came into existence as an amendment to the Social Security Act to strengthen the aspect of handling the cases of referrals by ruling out the prospect of physicians from engaging in self-referrals when referring patients to other medical stations services (Klein, 1998).

Inherently, Stark Law prohibits physicians from referring patients to other entities for Designated Health Services especially when the physicians or their keens have a direct or indirect financial link with the entity.  Most importantly, most individuals in and out of the medical sector perceive that Stark laws help protect insurance companies as well as the patients through its provisions that to an extend help prevent fraud, financial abuse as well as wastage as pertains time and money (Klein, 1998) .

For efficacy and levelheaded results, the stark law is enforced by the application of penalties alongside the implementation of the anti-kickback statute that essentially looks into everything case by case to identify any abuse, fraud or waste that is may be in one way or another associated with physicians “self referral “of patients(Vavonese, 1995).   .

As far as the Stark law is concerned, in the field of healthcare, the law allows physicians in their own efforts to purchase, lease and pay for advanced medical equipments such as the nuclear cameras leased by Dr. S and Dr. V in the case study provided.  In critical terms, through a vivid analysis of the two physician’s case the physicians aimed at preventing referring their patients to local hospitals.  However, as provided in the Stark laws, the physicians in the aspect of creating own referrals should ensure that during the time of in-office referrals they enlighten their clients by providing their clients with a list of other alternatives because they have minimum or no choices of any other service providers (Klein, 1998).

In this respect, it is evident that Dr.S. and Dr .V. had violated the ethical and legal parameters set by the stark law and the anti-kickback statute as far as the leasing and subleasing of the nuclear cameras is concerned because it is evident that they erroneously certified acquiescence despite the fact that stark law does not forbid internal referrals within an office or a group. Therefore, the claims that resulted from the sublease that stated that the endeavors violated the anti-kickback statutes were well structured. Nevertheless, the stark law provides a glowingly stated procedure in the equipment lease and sublease perspectives in that they provide harsh civil money penalties as well as probable disciplinary actions to any illegalities.

Through a critical evaluation of the two and the four physician’s cases, due to the impacts of the found unnecessary examinations endorsed to patients by physicians as well as the superfluous allegations that are evident in the provided case details, I do see the significance of the stark law in the medical sector. In addition, with the development of skills on the side of physicians for them to recognize the importance of being responsible and adherence to the stark law would unambiguous build the desire to generate finances legally and ethically.

The Stark law as quoted earlier is reinforced by the anti-kickback regulations which illegalize the payment of referral fees  in form of sale of products services  as well as the payment of kickbacks in hard cash or in kind.  As depicted in the provided case details, internal referrals, the leasing and the subleasing of the nuclear cameras by Dr.S. and Dr.V. were within the guidelines of the Stark and the Anti-Kickback Act (Vavonese, 1995).

In conclusion, the stark law and the Anti-Kickback regulations enclose wide prohibitions to thwart perceived deception and abuse of national health programs they differ in that Anti-kickback rules is strict, deals with referrals of any type and is much broader compared to the later as portrayed in the case details discussed above.

References

Klein, J. E. S. (1998). Stark Laws: Conquering Physician Conflicts of Interest, The. Geo. LJ, 87,       499

Vavonese, A. T. (1995). Medicare Anti-Kickback Provision of the Social Security Act-Is      Ignorance of the Law an Excuse fot Fraudulent and Abusive Use of the System, The.    Cath. UL Rev., 45, 943.