One law related to financial management in health care organizations that was covered in Weeks 3-4 is the Stark Law. The Stark Law, also known as the Physician Self-Referral Law, is a federal law that prohibits physicians from referring patients to entities in which they have a financial interest for certain designated health services covered by Medicare or Medicaid. The law was enacted to prevent financial conflicts of interest and to ensure that referrals are made solely on the basis of the patient’s best interests.
Under the Stark Law, designated health services include clinical laboratory services, physical therapy, occupational therapy, radiology, and durable medical equipment, among others. If a physician has a financial relationship with an entity that provides designated health services, the physician is prohibited from referring patients to that entity for those services, unless an exception applies.
There are several exceptions to the Stark Law, including the in-office ancillary services exception, which allows physicians to provide certain designated health services in their own offices, and the bona fide employment exception, which allows physicians to refer patients to entities in which they are employed.
The penalties for violating the Stark Law can be severe, including fines, exclusion from federal health care programs, and potential liability under the False Claims Act. Therefore, it is important for health care organizations to ensure that their financial relationships with physicians comply with the law and that referrals are made solely on the basis of the patient’s best interests.