Can I Give Financial Rewards to Doctors Who Lease My Medical Equipment?
Full Question:
Answer:
The Stark statute applies only to physicians who refer Medicare and Medicaid patients for specific services ("designated health services," or DHS) to entities with which they (or an immediate family member) have a "financial relationship."
Many of the Stark exceptions require that any compensation involved be calculated in a manner that does not take into account the "volume or value of referrals" between the parties. However, the regulations also state that time-based or unit-of-service-based payments are allowed "even when the physician receiving the payment has generated a payment through a DHS referral." For example, if a group of pulmonologists leases an X-ray machine from a group of family physicians who otherwise refer to the pulmonologists, the rent paid to the family physicians generating the referrals can be paid on a "per click" basis. In this type of situation, the amount paid to the physician who is making the referral will not violate the Stark statute as long as the payment per unit is at fair market value and does not change during the term of the contract that establishes the relationship.
To violate the anti-kickback law, one must knowingly and willfully offer or pay, solicit or receive remuneration in exchange for referring a patient for an item or service payable by the government, or for ordering or arranging for ordering any such item or service. The answer will depend on all the circumstances, such as whether federal funds are involved. I suggest you contact a local attorney who can review all the facts and documents involved.
Please see the following CA statute to determine applicability:
http://www.leginfo.ca.gov/cgi-bin/displaycode?section=bpc&group=00001-01000&file=650-657
For further discussion, please see:
http://www.aafp.org/fpm/20031100/27thes.html
http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?TITLE=42&PART=1001&SECTION=952&YEAR=2001&TYPE=TEXT
http://www.acr.org/SecondaryMainMenuCategories/BusinessPracticeIssues/FeaturedCategories/AntiKickback/AntiKickbackLawandSuspectFinancialAgreementsFAQDoc3.aspx
http://quitamguide.org/stark-law-limitation-on-certain-physician-referrals
