This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. List the key component of the Stark Law
2. State where one can obtain the Designated Health Services (DHS) list
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Jan 25 2023, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the test and evaluation. Upon registering and successfully completing the test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
As of 1992, the Stark law contains provisions that govern physician self-referral for Medicare and Medicaid patients. The law is named for United States Congressman Pete Stark, who sponsored the initial bill in 1989.
Physician self-referral is the practice of physicians referring a patient to a medical facility in which they or an immediate family member have a financial interest. It could be ownership, investment, or a structured compensation arrangement. Critics of the practice allege an inherent conflict of interest exists because the physicians can benefit from the referral. They believe that such arrangements may encourage over-utilization of services that drives up health care costs. They also assert that it limits or eliminates competition from other providers. On the other hand, in medically underserved areas, a physician may be providing a service that otherwise is not readily available.
A referral includes a request by a physician for an item or service payable under Medicare or Medicaid (including the request by a physician for consultation with another physician and any test or procedure ordered or performed by such other physician), or a request by a physician for the establishment of a plan of care that includes the provision of Designated Health Services (DHS). The DHS list can be found at the CMS website and is extensive, including ultrasound and other imaging services as well as outpatient pharmacy and physical and occupational therapy.
The law contains numerous exceptions that add to its complexities. For example, the referral-source physicians who are members of a physician group practice can refer a patient for imaging services or other DHS to be provided within the group practice without violating Stark. Qualifying as a “group practice” under Stark enables physicians to take advantage of certain exceptions, including the physician services exception and the in-office ancillary services exception. Group practices that provide DHS should review Stark’s group practice requirements to make sure they qualify under the definition, in order to protect their referrals under the in-office ancillary services exception.
Penalties for violating Stark can be quite harsh. They include denial of payment, refund of payment, imposition of a $15,000 per service civil monetary penalty and imposition of a $100,000 civil monetary penalty for each arrangement considered to be a circumvention scheme.
Fraud & Abuse Laws | Office of Inspector General | Government Oversight | U.S. Department of Health and Human Services (hhs.gov)
Becker’s Hospital Review: 15 Things to Know About Stark Law
Training community hospital residents for a future in the hospital’s community – what program directors should know about Stark Laws
AAFP: The Stark Truth About the Stark Law: Part I
CMS: Code List for Certain Designated Health Services (DHS)
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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