ED Coding & Reimbursement Alert - 2018 Issue 6
Reader Question: Beware Stark Self-Referral
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Article Overview
This reader Q&A discusses the Physician Self-Referral (Stark) Law in the context of surgeons considering an outpatient colonoscopy clinic. It explains the broad compliance issues the article is about, including financial relationships, referrals, and Medicare billing implications for designated health services. The article is aimed at physicians, practice administrators, and billing/compliance staff who need a high-level understanding of Stark-related risk areas.
Why This Topic Matters
Physician ownership and referral relationships can create significant compliance exposure when services fall within Stark law designated health services. Understanding the general framework helps practices recognize when legal review is needed before opening or billing through a clinic or center.
What You Will Learn
- What the Stark Law is concerned with in physician referral situations
- Why ownership and compensation relationships can matter for designated health services
- How outpatient facility arrangements may raise compliance questions
- Why legal counsel is recommended for fact-specific self-referral issues
Who Should Read This
- Physicians
- Surgeons
- Practice administrators
- Medical billing staff
- Compliance officers
- Healthcare attorneys
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