Question

How does Stark and anti-kickback statutes for compliance within a health services organization. what statutes might be address from compliance perspective as a current or future healthcare administration leader. Explain how a efforts to comply with these statutes address safe harbors and be specific about their relevance for a health services organization.

Answer 1

Statutes - are the laws passed by the legislative body. These are the laws to protect the human rights. There are civil.laws and criminal laws.

Stark law - This civil law is passed by the U.S legislative body to prohibit physician self referral of patients to other entity especially to those with whom the physician or any family member of physician has any financial relationships.This law is to prevent bribery.

Anti kickback - This criminal law is passed by the U.S. federal to prohibit knowingly and willfully accepting the bribes by the physician in return of the medial care the physician provided.

Both of these statutes ensures that the patient are getting right treatment at right place and at right price and nothing extra is paid by the patient for the health care services . Also ensures the quality of care provided by the physician , and also have a check on the referrals made by the physician. If there is any violation of these laws ,then the physician will have to pay penalities .

Some of the other statutes from the compliance perspective as a current or future healthcare administration leader are :-

a) False claim act - in this law there is prohibition of presenting a false claim for payment by the government for example a patient claims for payment of the procedure angiography ,but actually the procedure was not done .

b) Criminal healthcare fraud statute- in this law a person is punished if he presents a false statement to obtain the funds from a health care program.

c) Emergency Medical Treatment And Active Labour Act- accordingly to this law the health care system should provide services to the patient who is critically ill or in emergency even if they can't pay for the services.

d) Health Information Technology For Economic And Clinical Health Act- according to this law the health care system should use the information technology effectively in healthcare services.

The health care organisations must have a department to have a check on the issuees related to the health laws

The legislative body must have a check and a thorough record of the health care organisations compliance issues with the law . Those who don't follow or violates the law must be punished and also civil penalities or charges must be applied on him. This will help in the safe delivery of health care services and also make the persons understand the importance of the health laws.