Author Topic: Stark Law / Antikickback ?  (Read 4218 times)

AllAboutU

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Stark Law / Antikickback ?
« on: April 28, 2015, 12:16:43 PM »
Good Morning everyone!!!

I had a provider ask me about Stark Law and I researched the board and could not find information related to their question. This provider would like to do some marketing, on the materials they would like to put a code or the name of a therapist, or nurse to track the referral, when a referral come in they like to be able to give the therapist or the nurse a referral fee or bonus them some way. Another thought would be to let the therapist or nurse see that patient. There is also a thought of having volunteers go out and pass out marketing material and give them a finders fee if someone calls and is admitted to the agency. I have read and reread the Stark Law and understand that you can not pay the physician for referrals, but what about in this case? Since she is not directly interacting with the physician can she legally do this?

Thank you all for your help, it is appreciated!!! ;D

kristin

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Re: Stark Law / Antikickback ?
« Reply #1 on: April 28, 2015, 03:43:32 PM »
See here:

"What is the Federal Anti-Kickback Statute?

The Federal Anti-Kickback Statute is designed to protect patients and federal health care programs from fraud and abuse by inhibiting the use of money to influence health care decisions. The law plainly states that anyone who knowingly and willfully accepts or offers remuneration of any sort and in any manner intended to influence the referral of Medicare and Medicaid services can be held accountable for a felony."

http://www.telehealthresourcecenter.org/toolbox-module/federal-fraud-and-abuse-anti-kickback-statute


The part where it says "accepts or offers renumeration of any sort and in any manner" is what it sounds like you are talking about.

RichardP

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Re: Stark Law / Antikickback ?
« Reply #2 on: April 28, 2015, 03:52:47 PM »
States sometimes implement laws that are equal to or more stringent than the Federal Stark laws against self-dealing and anti-kickback.  If your provider wants to be absolutely certain, he needs to ask these questions of a health-care attorney who knows your state law.

Having said that, a physician may employ people and pay them to do work for him that is consistent with the type of medicine s/he practices.  Paying employees to advertise their business by positioning brochures and such in strategic locations should be OK unless your state has specific laws that prohibit this.  Are the therapist and nurse the employees of the provider you are speaking about?

What do you mean by this statement "... and is admitted to the agency"?  Is this a private practice?  A group practice?  A clinic of some sort?

AllAboutU

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Re: Stark Law / Antikickback ?
« Reply #3 on: April 28, 2015, 07:33:04 PM »
Richard:

They are a home health agency, the therapist will be employees eventually, some need volunteer hours for school first though. She wanted to use therapist still in school as volunteers and allow the patients that are admitted to the agency to be seen by the therapist that was responsible for the marketing.

The part that is confusing is how is it considered remuneration when marketers are paid employees and they market to physicians, we are not paying anything more what the salary or per visit rate would be.

I guess my confusion is how can companies have marketers and not be in violation of Stark Laws.

We are not forcing patients to use or company nor paying patients or doctors for our services, we are just wanting to pay therapist for their services to help them build their caseload. Or should we just hire a marketer and call it a day??

Thanks Richard and Kristin!!! ;D

 

RichardP

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Re: Stark Law / Antikickback ?
« Reply #4 on: April 29, 2015, 12:48:51 AM »
Or should we just hire a marketer and call it a day??

The key word here is hire.  That would make them your employees, or contract workers.  All they would receive is their pay in exchange for the work done.  If you hire therapists to do this work, you seem to be saying that they would be getting some sort of pay, plus patients.  Is this legal in your state?  I don't think anybody on this board knows.  You need to run the questions you have asked here past a health-care attorney who knows your state laws.  What you've written here is a good start.  Organize it into a letter and send it to someone who is authorized to answer your questions.

Medical Billing Forum

Re: Stark Law / Antikickback ?
« Reply #4 on: April 29, 2015, 12:48:51 AM »

AllAboutU

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Re: Stark Law / Antikickback ?
« Reply #5 on: April 29, 2015, 12:55:03 PM »
Thank you RichardP!!!! We've called our attorney.... we shall see what they say :-)

RichardP

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Re: Stark Law / Antikickback ?
« Reply #6 on: April 29, 2015, 02:06:59 PM »
You are welcome.  And can you let us know what kind of feedback you get from your attorney?

Medical Billing Forum

Re: Stark Law / Antikickback ?
« Reply #6 on: April 29, 2015, 02:06:59 PM »