The federal Stark Law applies to physicians when they make referrals (to an entity for a designated health service) for Medicare and Medicaid patients. This often needs to be analyzed when there is a financial agreement, including:
- Employment agreements
- Medical director agreements
- Rental space arrangements
- Ownership agreements
- Independent contract agreements
- Physician-owned distributor issues
- Equipment rental
Ultimately, physicians must not make a financial agreement with an entity with which they have a financial relationship. If the referral is made to an entity and the entity treats the patient and does everything correctly, there can still be a false claims act even though everything was done correctly on the billing or service — if the transaction is tainted, it is a false claim as the referral was illegal. It is important to realize that the Stark Law is hundreds of pages long and understanding it requires a comprehensive knowledge of health care law — and this is only on the federal level.
On the state level, regulations are similar but only involve investment or ownership interest. The Florida law applies to all referrals — workers’ compensation, PIP, private insurance, self-pay and self-referrals. While the Florida law applies to health services, it has a catch-all provision. It is often overlooked in transactions when people are going into ownership relationships with physicians. What’s unique is that both are per se — they do not require intent to violate. As such, all management agreements and management services agreements that involve referrals require review by counsel in order to protect against exposure.
Our Orlando Stark Law attorneys at Michael R. Lowe, P.A., are prepared to bring their expertise to work on nearly any Stark Law issue, including:
- Representing clients on advisory opinions
- Opinion solicitations from the Center for Medicare & Medicaid Services
- Requesting declaratory statements from the board of medicine
- Self-disclosures and administrative settlements with the Office of Inspector General on state or federal level
Ultimately, any transaction that is related to Stark Law or the Florida Patient Self-Referral Act must be reviewed by experienced health law lawyers in order to safeguard against catastrophe — we encourage you to get in touch and schedule a consultation if you are faced with these or related issues.
To schedule an initial consultation with one of our Florida Stark Law attorneys, call 407-332-6353 or contact us online.