Stark Law: A User's Guide to Achieving Compliance, 2nd Edition
Softbound Book + bonus CD-ROM
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This thorough and well-written resource is a reader-friendly guide to this complex Stark Law. Among other features, this guide:
- Sets out a simple, practical three-step process for determining whether a physician-provider arrangement implicates the Stark Law and, if so, whether the arrangement can be protected by a Stark Law exception.
- Includes scores of real-life examples-as well as diagrams, tables, charts, and checklists - to help demonstrate the application of the Stark Law in the real world and to help explain complicated concepts.
- Addresses each and every element of the Stark Law in detail. For example, the guide answers the following questions:
- What are the "designated health services" covered by the Stark Law?
- When has a physician made a "referral?"
- When has a physician made a referral "to" a provider?
- When has a physician made a referral to a provider for the "furnishing" of designated health services?
- When does a physician have a "direct" or "indirect" ownership or investment interest in a provider?
- When do a physician and provider have a "direct" or "indirect" compensation arrangement?
- and many more questions
- Covers each of the nearly three dozen Stark Law exceptions in detail, including the exceptions for hospital-physician recruitment, fair market value compensation, indirect compensation, and malpractice insurance subsidies.
- Highlights many of the gaps and ambiguities in the Stark Law that, to date, the government has not addressed.
The Stark Law is extraordinarily complex. Essentially, the law prohibits physicians from referring Medicare patients to certain providers - including hospitals, clinical laboratories, diagnostic imaging centers, and medical equipment suppliers - with which the physicians have a financial relationship. It also prohibits providers from billing for improperly referred patients.
Every day, hundreds of Stark Law inquiries are made by confused or uncertain executives, administrators, compliance officers, in-house lawyers and countless others. They know that "almost" isn't good enough. The Stark Law is a strict liability statute, so getting it "almost right" or having the "best of intentions" is irrelevant. The consequences of ignoring or misapplying the Stark Law can be severe. A provider or physician who violates the law is subject not only to substantial monetary penalties, but also to exclusion from participation in Medicare, Medicaid, and other federal healthcare programs.
For all of these reasons, Stark Law compliance is not an option - it is a critical component of an effective healthcare compliance program. The Stark Law will challenge you every day. This resource provides you up-to-date reference and guidance on the following topics:
- Background and analytical framework
- Designated health services
- Financial arrangements
- All-purpose exceptions
- Ownership interest exceptions
- Direct compensation arrangement exceptions
- Indirect compensation arrangement exceptions
- Recruitment and retention exceptions
- Sanctions, reporting, collateral consequences
- Advisory opinions
There are no compliance shortcuts!
Since issuing its long-awaited Stark II, Phase III Regulations, CMS proposed and finalized a host of additional regulations, notices, and clarifications, including a major final rulemaking in August 2008. The number and speed of these changes add yet another layer to the already complex web of rules and regulations governing Stark Law compliance. Your copy of Stark Law: A User’s Guide to Achieving Compliance delivers:
A thorough explanation of how the newest regulations and the impact of the Law as a whole, as well as your organization
Access to a comprehensive outline of the entire Law in one location, from the initial proposed regulations through the most recent updates
Scores of easy-to-understand case studies, which illustrate the application of the Law
A searchable CD-ROM to help you find specific citations
With such high stakes, your organization needs Stark Law: A User’s Guide to Achieving Compliance to remain on top of the recent amendments to the Law.
The authors are Ramy Fayed, Chris Janney, Marci Rose Levine, Lisa Ohrin, and Gadi Weinreich, partners in the health law group at Sonnenschein Nath & Rosenthal, LLP, an international law firm with more than 800 attorneys and other professionals in 13 cities. The authors are seasoned health lawyers, who counsel hospitals, health systems, suppliers, practitioners, and other health care organizations on the Stark Law and other fraud and abuse, regulatory, and transactional matters. The authors have lectured and written extensively about the Stark Law and other health care topics.
With more than 17 years of experience, HCPro, Inc. is a leading provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance. The company's mission is to meet the specialized informational, advisory, and educational needs of the healthcare industry. As an acknowledged industry authority in healthcare regulation and compliance, HCPro focuses on providing its expertise in the areas of accreditation, medical staff affairs, credentialing, privileging, medical record management, regulatory compliance, nursing, quality/patient safety, infection control, and workplace safety.
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