Oberheiden & McMurrey, LLP Blog

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Investigating Health Care Fraud Through A Civil Investigative Demand (CID)

Categories: False Claims Act

A common approach federal authorities use to investigate health care fraud is through civil investigative demands (CID).  CIDs are requests for documentation that prosecutors issue in connection with a federal investigation.  Compliance with CIDs is required regardless of whether the recipient is charged with a violation or is personally under investigation.  In the context of…

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What You Should Do When You Are Under Stark Law Investigation?

Categories: Health Care Law

Stark Law investigations

About the Stark Law The Stark Law (42 U.S.C. § 1395nn), also known as the Physician Self-Referral Law, imposes limitations on a physician’s right to refer patients to medical service providers in which the physician (or a family member of the physician) has a financial interest or a financial relationship.  The Stark Law only applies…

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What Is the Personal Service Exception under Stark Law?

Categories: Health Care Law

stark law

The Ethics in Patient Referrals Act (Stark) prohibits physicians who have financial relationships with entities from making referrals to those entities for the furnishing of designated health services (DHS) reimbursable by Medicare, subject to certain exceptions. See 42 U.S.C. § 1395nn(a)(1).  To limit the wide and potentially unintended application of this law, the Stark Law…

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What Are the Compensation Arrangement Exceptions to the Stark Law?

Categories: Health Care Law

Stark Law

Under the Physician Self-Referral Law (42 U.S.C. § 1395nn), or Stark Law, physicians are barred from referring Medicare/Medicaid beneficiaries to a “designated health services” (DHS) provider in which the referring physician (or his immediate family member) has a “financial relationship.” Because maintaining the Stark Law without exceptions would make the practice of medicine almost impracticable,…

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What Are the Ownership and Investment Interest Exceptions to the Stark Law?

Categories: Health Care Law

Stark Law Exceptions

The Stark Law, officially named the Physician Self-Referral Law (42 U.S.C. § 1395nn), forbids physicians to refer a Medicare/Medicaid patient to a “designated health services” (DHS) provider that the referring physician (or his immediate family member) has a “financial relationship” with, unless an exception applies.  Similarly, the Stark Law disallows DHS providers from billing Medicare…

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