How to pro­tect against Stark whis­tle-blower law­suits

Modern Healthcare - - NEWS -

Get ad­vice from lawyers who are ex­perts in the field.

Mind your ex­cep­tions There are about two-dozen spe­cific ex­cep­tions for buy­ing pa­tient re­fer­rals, in­clud­ing some that al­low fair-mar­ket pay­ments for staff doc­tors who re­fer pa­tients.

Make sure you meet ev­ery con­di­tion of the Stark ex­cep­tion.

Hire an ex­pert val­u­a­tor Make sure you are pay­ing fair­mar­ket value for physi­cian ser­vices. Re­ly­ing solely on pub­lished salary lists for med­i­cal spe­cial­ties is not enough.

Form a com­pli­ance depart­ment Make sure com­pli­ance of­fi­cials re­port di­rectly to the board or the CEO, not the le­gal depart­ment.

Con­duct exit in­ter­views Find out if em­ploy­ees are leav­ing be­cause they don’t like what they were asked to do.

Watch what you say in e-mails

Have le­git­i­mate rea­sons for hir­ing doc­tors If it’s to fill gaps in cov­er­age to bet­ter serve the com­mu­nity, that’s fine. If it’s to gain re­fer­rals, that could be a Stark vi­o­la­tion.

Au­to­mate, track and up­date physi­cian con­tracts

Have a for­mal sys­tem for in­ves­ti­gat­ing and re­solv­ing em­ployee com­plaints

Self-re­port If a vi­o­la­tion is doc­u­mented, don’t wait for a whis­tle-blower law­suit. Medi­care may ac­cept re­pay­ment of funds. Or sel­f­re­port­ing can help speed up the res­o­lu­tion process and gain le­niency.

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