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Charting the changes: How the Stark Law shapes healthcare today

Healthcare regulation is an ever-evolving landscape, and the Stark Law serves as a prime example of this progression. Originally enacted to prevent conflicts of interest in physician referrals and close a loophole in the Anti-Kickback Statute, the Stark Law has undergone significant changes to address the complexities of modern healthcare delivery.

Understanding Stark Law

The Stark Law, also known as the physician self-referral law, prohibits physicians from referring patients to entities with which they have a financial relationship for certain designated health services paid for by Medicare or Medicaid, unless an exception applies.

Over time, the Stark Law has adapted to the changing landscape of healthcare, with amendments and new regulations addressing emerging trends and technologies. These include the following developments:

  • Introduction of exceptions for value-based arrangements
  • Clarifications to accommodate integrated care and alternative payment models

The evolution of the Stark Law reflects a broader trend in healthcare regulation, aiming to balance the prevention of unethical practices with the facilitation of innovative care models. As healthcare continues to advance, regulations like the Stark Law will likely continue to evolve.

The application of Stark Law

The Stark Law is a strict liability statute, meaning that a violation does not require intent. The Centers for Medicare and Medicaid Services (CMS) takes violations seriously, settling over 100 self-disclosures for more than $9 million in 2022 alone.

The future

The Stark Law continues to evolve, most recently with the updated exception that allows improved mental health services.

Physicians should stay informed about these changes to ensure compliance and to leverage opportunities for improved patient care. It is wise to consult with a healthcare attorney or compliance expert for more detailed information on how these regulations can impact your practice.

Attorney John Rivas is responsible for this communication.