Florida Kickbacks & Stark Fraud Lawyer
Most people have heard the term kickback in reference to the unlawful act of paying, soliciting, or receiving something of value in exchange for any type of medical referral. Many, however, are unaware that there is actually a specific portion of the Social Security Act, known as the Stark Law, that bars physicians from even making self-referrals to Medicare patients. Essentially, under this law, physicians cannot refer patients to an entity that provides certain health services if they or their family members have a financial interest in that company. There are, however, exceptions to this general prohibition, making it especially important for those who believe that an employer is violating this law, to speak with an experienced Florida kickbacks & Stark fraud lawyer before proceeding.
What is the Stark Law?
The Stark Law is a part of the Social Security Act that prohibits physicians from referring Medicare patients to certain healthcare providers for specific designated health services. This prohibition applies primarily to physicians who make self referrals, or who refer a patient to an entity in which they, or one of their family members, has a financial interest. There are, however, a few exceptions to this general ban. One physician can, for instance, refer a patient to another physician if they share a practice. Intra-family rural referrals are also permitted in areas where the healthcare industry is relatively small.
Designated Health Services
A kickback under the Stark Law occurs when a healthcare professional provides financial incentives to other healthcare providers in exchange for referrals to Medicare or Medicaid patients. It’s important to note that the Stark Law only prohibits healthcare providers from self-referring for specific services, known as designated health services, which includes:
- Clinical laboratory services;
- Occupational and physical therapy;
- Speech pathology;
- Radiology and other imaging services;
- Home health services;
- Radiation therapy;
- Hospital services;
- Outpatient prescription services; and
- Services involving medical equipment, supplies, and devices.
This law also extends to the entity that provides these types of services, as these groups are barred from submitting claims to federal healthcare programs if they were wrongfully referred.
The Stark Law is a civil statute, which means that those found in violation of its terms won’t face jail time, but can be required to reimburse the government and wronged patients for the amounts paid pursuant to the prohibited referral. Other penalties include the denial of payment to the DHS provider, civil monetary penalties for each scheme, and exclusion from Medicare. In some cases, a physician could also be held liable under the False Claims Act, which rewards whistleblowers for bringing Medicare and Medicaid fraud to the attention of the federal government by awarding them with between 15 and 30 percent of whatever is recovered in compensation.
Set Up an Initial Consultation Today
For help filing your own False Claims Act lawsuit against a physician who is in violation of the Stark Law, please call the experienced Florida kickback and Stark fraud lawyers at Rabin Kammerer Johnson at 561-659-7878 today.