Federal Regulators Consider Updates to Physician Self-Referral Law

Efforts to Ease Doctor Fraud Law May Fall Short, Lawyers Warn
– Bloomberg Law

Manatt’s Randi Seigel, a partner in Manatt Health, spoke with Bloomberg Law on potential changes to the physician self-referral law, also known as the Stark law.

According to Bloomberg Law, this law prohibits doctors from referring Medicare patients to a hospital or healthcare facility if the doctor, or his or her immediate family, has a financial stake in the facility.

Centers for Medicare & Medicaid Services administrator Seema Verma has promised to make “the most significant changes to date” to its regulations under the law.

The steep penalties set out by the Stark law for violators include a $15,000 fine for every medical service, exclusion from federal health programs and forced repayment of Medicare claims collected from improper referrals.

Seigel said violation of the Stark law could have significant consequences for doctors and medical facilities.
“Every referral made that was related to a financial relationship that violates Stark is a tainted claim,” she said. “A hospital can easily have to repay several million dollars just related to one physician.”