Stark Law, Anti-Kickback Law, and Other Federal and State Laws Regarding Referrals

We assist hospitals, health systems, and other clients in analyzing proposed transactions with referring physicians to minimize risks under Federal and State statutes and regulations which limit referrals of patients whose care is paid for in whole or in part by Medicare, State Medicaid programs, and other programs using government funds. These include the Federal Stark Law, as interpreted under the extensive regulations promulgated by the Centers for Medicare and Medicaid Services, and the Federal Anti-Kickback Law and the extensive safe harbor regulations under it promulgated by the HHS Office of Inspector General.

As virtually every sophisticated health care provider knows, whenever a hospital or other institutional provider contracts with a physician who is a potential referral source, or a physician or group practice contemplates owning ancillary services such as an MRI, CT scanner, or other sophisticated imaging device, and in many other situations, these Federal and State statutes and regulations must be analyzed. Government agencies at all levels have stepped up their enforcement efforts, and the penalties for violations can be severe.