There are many different types of whistleblower claims that involve physicians and other medical providers defrauding the government. Some of the most common involve Stark Law violations. Stark Law was enacted over two decades ago and was meant to ensure that patients receive the best care possible, and that physicians always work in their best interests. Today, Stark Law has become complicated, and it seems the laws are changing all the time. If you work in the medical industry, below are five things you should know about Stark Law to ensure your employer operates honestly and within the confines of the law.
Stark Law Bans Self-Referrals
When it was enacted in 1989, the concept behind Stark Law was relatively simple. The law was intended to ban self-referrals made by doctors for certain services when a patient was covered through Medicare or another government program. The law was named after Representative Pete Stark, the Democrat from California that sponsored the bill.
The Law has Become Complex
Although the original law was fairly straightforward, today it has become quite complex. The law was expanded on in 1995 and a number of regulations implementing the physician self-referral law went into effect. Today, there are many different statutes that are collectively referred to as Stark Law.
There are Many Exceptions to Stark Law
Making the law even more complex, Stark Law also has many exceptions. Some of these include vaccines, immunizations, and screening tests, provided they are not administered too often. This makes it difficult for whistleblowers that think they may have a claim, but are unsure of whether the referral is an actual violation.
There are Harsh Penalties for Violations
Any physician or medical organization found in violation of Stark Law could face serious repercussions. Violators of the law are required to repay all Medicare funds that were paid as a result of the violation. In some cases, this could total millions of dollars. Offending organizations are also at risk for being excluded from Medicare and face potential liability under the False Claims Act.
There are Incentives for Blowing the Whistle on Violators
Employees who notice their employer is violating Stark Law have many incentives to blow the whistle on the wrongdoing. Not only will it make things right and stop fraud against the government from occurring, but whistleblowers can also receive as much as 30% of the total fine as compensation. In 2016, the penalties for Stark Law violations were increased to a range between $10,781 and $21,563, of which a whistleblower would receive 30%.
Think You May Have a Whistleblower Claim? Call Our California Qui Tam Lawyers
Stark Law is at the center of many whistleblower claims, but it is extremely complex. If you think your employer is in violation of the law, it is important that you contact our San Francisco qui tam lawyers at Willoughby Brod, LLP, as soon as possible. We know the law and will apply it to your claim to determine if your employer is acting unethically. If so, we will hold them accountable for their actions and guide you through the whistleblower claims process. Call us today at (800) 427-7020 to schedule your free consultation so we can get started on your case.