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Addressing Stark and Anti-Kickback Statutes
As you have examined this week, Stark and anti-kickback statutes are in place to ensure that health services organizations are in compliance for engaging in fair and equitable business practices. While adherence to these statutes is not necessarily different for a wide variety of organizations, healthcare administration leaders must be careful to ensure that healthcare delivery and health services are made available and delivered in a fair and legal manner.
For this Discussion, review the resources for this week and consider how Stark and anti-kickback statutes contribute to a health services organization’s policies for health services delivery. Think about safe harbors and how these relate to health services organizations.
Post a description of Stark and anti-kickback statutes for compliance within your health services organization. Then, describe what statutes you might address from compliance perspective as a current or future healthcare administration leader. Be specific and provide examples. Explain how your efforts to comply with these statutes address safe harbors and be specific about their relevance for your health services organization.Addressing Stark and Anti-Kickback Statutes
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Discussion
Continue the Discussion to 2 of your colleagues and describe a personal experience where you, as a current or future healthcare administrator, might have engaged in the public policy process. If you do not have any personal experience, describe how you might assert your role as a healthcare administrator in the public policy process.
Each Colleagues 250 words or more (Colleague 1 250 words, Colleague 2 250 words, Total 500 words)
Colleague 1
The Stark Law is a federal law that prohibits physicians from self-referral. It was originally enacted in 1992 and aimed to prevent physicians from referring Medicare recipients to labs and other service providers where they had a financial relationship (Taormina, 2013). Another law aimed towards combating healthcare fraud and abuse is the Anti-Kickback Statute passed years prior to the Stark Law, in 1972 (Weinstein, 2020). The federal law states that physicians cannot trade referrals for “anything of value” for Medicare recipients (Weinstein, 2020). Addressing Stark and Anti-Kickback Statutes
Healthcare organizations and their physicians must remain compliant with all federal laws, including those in place to prevent fraud and abuse. As an administrator, clear policies and procedures put in place to ensure compliance with legislation, such as the Stark law and the Anti-Kickback statute, it is imperative and to update those policies regularly to take into consideration any revisions (Maida & Alarif, 2020). It is hospital leadership’s responsibility to enforce these policies and ensure corrective action is taken in instances where they are not followed.
References
Maida, T., & Alarif, N. (2020). What a Difference a Year Makes– Key Anti-Kickback Statute and Stark Law Developments. Journal of Health Care Compliance, 22(4), 5–14. https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=1&sid=8c1075e4-c1cd-4b2a-896f-1e7773c26d47%40sessionmgr102
Taormina, M. (2013). The stark truth: what your physician clients should know about stark law and the anti-kickback statute. Journal of Health Care Finance, 39(3), 85. PMID: 23614270.
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Colleague 2
The main purpose of the Stark Law is to govern self-referrals by physicians to prevent the occurrence of and address potential conflicts of interest. To ensure that it deals with the conflicts effectively, the legislation has undergone several phases of amendments that establish and expand restrictions and exceptions.
Following its enactment, the Centers for Medicare and Medicaid Services has established comprehensive regulations that are heard towards illuminating the limits of the Stark Law. Moreover, physicians and designated health services entities have been flexible because of the exceptions to the general rule forbidding self-referrals. While the regulatory scheme managing self-referrals is comprehensive and complex, it has costly consequences for non-compliance. Consequently, physicians and entities providing designated health services need to carefully plan their relationships and see for help establishing compliance with the law.
Stark Law has been effective in governing physicians referrals though it has attracted several concerns, including the possibility of creating a captive referral system. Its effectiveness emanates from its ability to ensure that self-referrals do not occur. However, it is important to make necessary amendments to the law to address its concerns.
Reference:
U.S. Department of Health and Human Services. (2009). National healthcare quality report 2009. Rockville, MD: Agency for Healthcare Research and Quality; March 2010. AHRQ publication no. 10-0003. Retrieved from: HTTP://www.ahrq.gov/qual/nhqr09.pdf.