Stark Law Exceptions that Might Apply to You

In today’s video, we discuss some exceptions
to Stark Law, which deals with improper referrals by physicians and healthcare practitioners. If you’ve watched some of our previous videos,
you’ll know that we already covered a couple of these, like physician services and in-house
ancillary services. But many of our clients have asked us whether
there are other categories of exceptions to Stark Law, and what they are. I’m Michael H. Cohen, founding attorney
of the Cohen Healthcare Law Group. We’ve advised over a thousand healthcare
industry clients on similar healthcare and FDA legal issues. Today, I’m going to cover some more exceptions
to Stark Law governing referrals by physicians and healthcare practitioners. By the time we get through, you’ll know
about three more categories of exceptions to Stark that might apply to your healthcare
business. The first category is services furnished by
an organization to its enrollees. Physicians can make referrals to organizations that provide
a prepaid health service. Examples of prepaid health plans are approved HMOs, approved CMPs,
plans approved by the Centers for Medicare & Medicaid Services, as well as other plans
identified in Stark Law. This exception category applies to organizations and entities that
contract with the organization. Another category is for academic medical centers.
Physicians who has a financial relationship with an academic medical center can make referrals
to that center without running afoul of Stark law if certain conditions are met. The physicians
must be bona fide employees of the medical center, have a valid state license in the
state the center is located, be members of the facility’s faculty, and provide clinical
teaching services at the center for which they are compensated. In addition, the center
must meet other criteria for approval that are detailed in Stark. If all the above conditions
are met, the exception will apply. A third exception category exists for implants
furnished by an Ambulatory Surgery Center. The acceptable implants include cochlear implants,
intraocular implants, prosthetic device implants, and others. The implant procedure must be
done at the Ambulatory Surgery Center by the referring physician or by one who belongs
to the referring physician’s medical group. As you can tell, each of these exceptions
have detailed requirements and conditions that we can’t address in the span of a video. But an experienced healthcare lawyer can give
you the full picture on these three as well as on whole other exception categories that
we didn’t touch on today. Thanks for watching. If you still have questions,
click on the link below,, to send us a message or book an appointment. We know that Stark law is very deep, and the
exceptions are very nasty, and that there are exception within exceptions within exception.
As well, typically where you have a Stark violation, you also have to contend with the
anti-kickback law. Further, even if you don’t have Federal Stark
applying, or the Federal anti-kickback statute, more than likely, you’ll have applicable state
law which contains mirrors to the Stark self-referral law on the federal side, on the federal anti-kickback
statute. We look forward to you connecting with us, and we look forward to speaking with you soon.

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