You have discovered that one of your physicians is violating the Stark law by sending patients...

You have discovered that one of your physicians is violating the Stark law by sending patients to an imaging center in which she has an ownership percentage. She offers you a monthly consulting fee if you don’t say anything and let her continue to refer patients. She tells you that the facility is good and the patients are not being harmed.

a. Explain what the Stark law is.

b. Discuss what you would do in this situation.

c. What consequences should be taken against the physician, if any?

Solutions

Expert Solution

a) The Stark law is the kind of fraud and abusive law that make the restrictions to the physicians intension to refer the patients to those health care services or centers , in which they have a financial relationship . This financial relationship may be of direct or indirect involvement of physician or and member of their family .

This law is not the criminal statute but it will result into the penalties.

b) If the physician offering me the bribe to do this fraud so I ll going to take some serious and strict actions against her .Because , if we will continue doing such kind of abusive in this kind of profession so it will be very risky for patients . She can do all this fraud for her greed and more money either she confessed me that there are alot f facilities and stuff but still it is considered as a fraud . I will try my best in taking action against this issue and inform the higher authories that this kind of activity should not repeated again .

c) The consequences for such behaviour and this abusive activity of physician should be taken as either the violation of the Stark law is unintensionally or by knowingly . The penalties and prohibitions should be imposed in such cases in which the physician voilate the stark law.

The action should be taken against those by applying the Civil money penalties and in severe cases the physician should be excluded from participating in the medicare and its related programs .

Some times the center or any any healthcare service which are involve in this violation ahould be punished and get the penalties by sanction the no billing and resist the payment of that service .

All above consequences should be taken against the physician who violate the Stark law .

Nightingale answered 1 year ago

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