Over time, AAFP's journal Family Practice Management has answered many questions about anti-kickback laws and Stark regulation. We have compiled a list of frequently asked questions based on FPM's information.
Frequently Asked Questions about Anti-kickback and Stark Compliance
What is the Anti-kickback rule?
-- In 1972, Congress passed the anti-kickback statute which made it illegal for providers, including doctors, to knowingly and willfully accept bribes...
What is Stark III?
-- Stark III is actually Phase III of the physician self-referral prohibition...
What is Stark II?
-- Stark II is Phase II of the law named after California Rep. Pete Stark who authored this legislation. The purpose of the law is to...
What are the exceptions to Stark?
-- Exceptions to Stark are many and each has its own qualifying provisions in the law...
Are Stark and the Anti-kickback legislation the same?
-- These two laws are separate but also integrated into each other. The laws refer to one another...
I am considering a venture how can I find out how not to violate the statutes?
-- You may want to hire a health care consultant or attorney who is knowledgeable in this area...
What are the designated health services as defined by Stark?
-- There are 11 categories subject to the referral restrictions...
What constitutes a referral under Stark?
-- Any of the Stark Designated Health Services which you request...
Does Stark require my employer to make salary and benefits changes?
-- I am one of several employed physicians at my institution. Our institution plans to put all physicians on salary, based strictly on gross revenue...
Does Stark legislation apply differently to PAs than to physicians?
-- I work in a clinic and hospital that is county-owned and run by a hospital board. Recently the board consulted an attorney about one of our physician assistant's...
Are there limits to incentives and bonuses that can be offered?
-- You need to be aware of legal and regulatory limits that govern incentive and bonus plans...
Can I offer patients coupons for optional procedures or for local businesses?
-- Unfortunately, offering items of value to your patients for less than fair market value is a complex area fraught with trouble. Several standards apply...
Is it permissible for physicians to be paid for serving on hospital committees?
-- If the services provided by the physicians on the committee are to the economic benefit of the hospital, a fair market value payment...
Are there legal concerns if the the hospital where I have priveleges offers professional discounts to physicians?
-- Yes, there are legal concerns. The anti-kickback statute prohibits an entity from giving something of value, such as discounts...
Can I join with a group of surgeons, internists and other specialists to create an ambulatory surgical center (ASC) for our community?
-- Nothing in Stark II prevents primary care physicians from participating with surgeons in ASCs, but this doesn't mean that they should not be concerned with Stark II at all...
Does the Stark law apply to a counselor I employ?
-- For example, if I refer a patient to the counselor for stress or pain management, is it legal to bill for that session using my tax ID number?
What is an acceptable arrangement to have an outside private mobile radiology company come to my office to do ultrasound studies on my patients?
-- Before entering into such an arrangement, you should consult legal advice. There are many things to consider...
I would like to share my expenses in setting up Ultrasound services with a local surgeon who is also interested. Is this allowed under Stark?
-- Ultrasound is listed as one of the "designated health services" in the Stark regulations. The regulations reflect CMS's interpretation that Stark encompasses any entity that provides...
If I had a rural office would Stark apply?
-- There is a rural exception in the Stark law and regulations. Specifically, section 1877(d)(2) of the Social Security Act provides that designated health services furnished...
Regulatory Compliance
