Research And Provide In-Depth Discussion On Stark Law (Essay Sample)

Stark Law
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Stark Law Case Study Discussion
What is Stark Law?
The Ethics in Patient Referrals Act, popularly known as Stark law is a set of federal laws that prohibit the act of physician self-referral (Wales, 2003). The Act specifically focuses on the referral by physicians of Medicaid or Medicare patient to an organization that provides Designated Health Services (DHS) if the physician has a financial relationship with that particular organization (Wales, 2003). The law covers 11 designated health services and provides a complete ban on all Medicaid and Medicare payment for services that fall under the statute where the referring physician has a personal or close financial stake (Cohen, 2014). Under Stark Law, the term financial relationship is used to refer to investment interest or ownership in the health care organization or an arrangement of compensation between the organization and physician (Cohen, 2014). This paper reviews the Dr. S and Dr. V case with the objective of providing a determination as to whether or not their actions violated the Stark law.
Case Analysis
The first step is determining if there is a financial relationship between the two physicians and the Hospital. From the information provided it is evident that there was a financial relationship between the physicians and the health facility because they had admitting privileges at the hospital. The financial relationship is also evident from the fact that the hospital had subleased the nuclear imaging machine from the physicians this discloses the fact that there is a compensation arrangement between the physicians and the hospital. The sublease implied that Dr. V and Dr. S would get compensation from the hospital for the use of the nuclear imaging device and thus they would benefit directly from the use of the device.
The next step in finding out whether Dr. S and Dr. V violated Starks Law is to determine whether the service in question is a DHS service. From the case, the service in question is nuclear imaging. Nuclear imaging is classified under nuclear medicine which is regarded as a radiology service thus based on this it is logical to conclude that the service in question is a DHS service.
Findings
Based on the facts of the case it is logical to conclude that because of the sublease, the two physicians violated the Stark law. As indicated in the analysis section, the fact that the two physicians had subleased the nuclear imaging device to the hospital meant that they were eligible to receive compensation from the use of the device by the hospital. Also the fact that the service in question qualifies as a DHS service serves to strengthen the argument that the Stark law had been violated by the two physicians.
The Stark law is built on the principle of preventing physicians or their family members from benefiting from referrals made in the execution of their duties (Sutton, 2011). Every time DR. S and DR. V referred patients to use the nuclear imaging device that they had subleased to the hospital, they received compensation for its use as the hospital was obliged to pay them for it. From this, it is evident that the two physicians violated the Stark law.
However, it is essential to point out the fact that the violation occurred only if the two physicians referred patients to use the nuclear imaging device. In the event that the device remained in their office, but they did not make any referrals for its use, then they ...