Compliance & RegulatoryQuestion 90 of 100

The physician self-referral law (the Stark Law) generally prohibits a physician from:

a.Referring any patient to a specialist
b.Billing Medicare for office visits
c.Referring Medicare patients for certain designated health services to an entity with which the physician has a financial relationship, unless an exception applies
d.Accepting insurance

Explanation

The Stark Law bars physicians from referring Medicare patients for specific designated health services to entities in which the physician or an immediate family member has a financial interest, absent a qualifying exception. Unlike the Anti-Kickback Statute, Stark is a strict-liability civil law that does not require intent. Claims resulting from prohibited referrals are not payable.

Law Reference: CMS

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