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Stark Law and Radiology

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Stark Law and Radiologic Imaging
Stark Law: some people consider it a highly needed federal law to help protect patients and insurance companies; others dread even the name and feel that it is just another way the federal government interferes with individuals’ daily lives, and see it as an unwanted intrusion into the practice of medicine. What is Stark Law and why was it enacted?
Stark Law is actually three separate provisions that govern physicians’ self-referrals, mostly for payment by Medicare patients; it is also known as “the self-referral law.” “The law is named for United States Congressman Pete Stark, who sponsored the initial bill (“STARK LAW,” n.d., para. 1). The first phase became effective on January 1, 1992 (Taromina, 2013, p. 83). It prohibited a physician from referring a patient to a clinical laboratory with which they, or an immediate family member, had a financial relationship.
The second phase became effective on January 4, 2001 (Taromina, 2013, p. 83). Stark II applied the already-enacted laws to Medicare and Medicaid patients, and extended the restrictions to include additional designated health services (DHS): physical therapy, occupational therapy, speech therapy, radiology services, radiation therapy, durable medical equipment and supplies, parenteral and enteral nutrients, equipment, and supplies, prosthetics, orthotics, and prosthetic devices and supplies, home health services, outpatient prescription drugs, inpatient and outpatient hospital services, and clinical laboratory services (Burgess, n.d., para 8). It also set guidelines for physician recruitment and retention (Reynolds, 2004).
Phase II states that “any DHS performed as a result of a prohibited referral cannot be billed to any payer, including the patient” (Chase, 2001, para. 3). In addition, any physician or entity that violates Stark II may be subject to significant civil…...

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