STARK 101: essential questions for every Stark analysis

Navigating the federal physician selfreferral law (enacted as Section 1877 of the Social Security Act and commonly referred to with its accompanying regulations as the Stark Law) can often perplex even the most seasoned lawyer. For the compliance officer, understanding whether Stark applies to a proposed or existing arrangement is an essential first step in evaluating that arrangement. For example, knowing when Stark applies is key to determining whether that unsigned or missing lease is problematic.

In practice, Stark issues can generate a number of perplexing questions. Does Stark apply to arrangements with physician assistants? What if the arrangement is with a physician, but that physician is not practicing medicine or does not personally have a financial relationship with the hospital? How does Stark apply to these and other situations?

This article provides an introduction to Stark and offers some simple tools to help guide compliance officers, executives, new lawyers, and others in evaluating whether Stark may prohibit a proposed or existing arrangement. Two general questions should guide every Stark analysis: Does Stark apply to the arrangement? If Stark applies, does the arrangement fit into an exception?…

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