Articles Tagged with Stark Act law firm

hush-naidoo-382152-copy-300x200There 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.

samuel-zeller-360588-copy-200x300Though similar in purpose, the Anti-Kickback Statute (AKS) and Stark Law have many differences that are often overlooked or ignored by the general public. If you believe you have witnessed a form of healthcare fraud but are unsure whether the fraudulent act was a violation of the AKS or Stark Law, contact one of the experienced AKS and Stark Law attorneys at Willoughby Brod today for your free case review.

What is the Anti-Kickback Statute?

The AKS provides that physicians and hospitals are not permitted to refer patients to other healthcare providers in exchange for something of value, whether in cash or another form. The purpose of this statute is to ensure that referrals are genuine and based on merit rather than based on familial or professional networks.

The relationship between health care and money is the crux of some of the biggest policy debates of our time.  Still, while much is debated, there are also many principles that most Americans agree should hold true.  One such maxim – Medical decisions should be based on the best interests of patients, not providers own financial well-being.  This precept is reflected in several laws including the Anti-Kickback Statute and the Stark Act and enforcing these rules is one of the goals of our work as a whistleblowers’ law firm for health care fraud issues.

$115 Million Settlement Resolves Case Alleging Health System’s Bonuses Violated Law

Just last week, the Justice Department (“DOJ”) announced a major settlement in a health care fraud case involving allegations of improper financial relationships between health care providers and their referral sources.  The lawsuit claimed that Adventist Health Systems, a healthcare organization with facilities in 10 states, billed for the services of employed providers who were paid bonuses that, contrary to law, were based on a formula that considered the value of the referrals to the hospital system.  More specifically, the suit alleged that doctors received monetary bonuses tied to the number of tests and procedures they ordered.  Adventist agreed to pay $115 million to settle these and other fraud allegations, but did not admit to any wrongdoing.