Stark Law Explained

In this episode of Group Practice, host Neal Goldstein explains the federal Stark Law, the prohibition on physician self-referrals, one of the two major healthcare fraud and abuse laws governing physicians. He describes Stark as a complicated but important statute enacted in 1989 and expanded in 1993 to cover ten “designated health services” (DHS), including imaging, physical therapy, durable medical equipment, and hospital services. Neal emphasizes that Stark is technically a Medicare and Medicaid payment law, but it functions like a fraud and abuse statute because violations require repayment and may trigger liability under the False Claims Act. Neal breaks the law down into its core components as he did in the law school course he taught. He also discusses how Stark affects not just physicians, but also hospitals with the expansion of the law in 1993, making Stark a two-headed monster in the health care industry.