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Stark and Physician Self-Referral Laws


Stark Laws, also known as the Ethics in Patient Referrals Act, prohibit physician self-referrals.  These laws are codified at 42 U.S.C. Sec. 1395 nn and 42 C.F.R. Sec. 411.350 – 389. A physician self-referral occurs when a physician refers a patient to another entity (e.g. one which provides lab services or therapy services) with which the physician has a financial relationship.  Stark generally prohibits two activities:

  • Physicians making referrals for designated health services to entities with which they or their immediate family have a financial relationship; and
  • Entities billing Federal health care programs for any such improperly referred services.

The theory behind the statute is that because a physician will benefit financially from the referral, the physician may refer patients without sufficient medical justification, and, as a consequence, order either duplicative or unnecessary services for the medical issues presented. This practice could result in increased health care costs and over-utilization of medical services. Moreover, self-referrals could also limits competition among local health care providers, resulting in a potential decrease in the quality of health care services.

Liles Parker represents physicians dealing with Stark concerns. Our attorneys have years of experience assisting providers in Stark self-referral issues and are skilled at providing guidance regarding compliance with the law. If you have any questions or concerns regarding potential violations of Stark laws, please contact our office at 202-298-8750.
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