The physician self-referral or "Stark" law—first enacted by Congress in 1989, and amended many times since—was intended to prevent overutilization stemming from arrangements in which physicians benefited financially from their referrals for ancillary services. Suspect arrangements included a physician's ownership interest in an entity that furnishing a service, or receipt of compensation tied to the number of referrals given out. As originally enacted, the law applied only to clinical diagnostic laboratory tests. Congress amended the law in 1993 and 1994 to add additional services, which include, among other things, therapy services and imaging.
The Centers for Medicare and Medicaid Services has promulgated a number of regulations over the years, implementing the Stark law as it continually tries to close loopholes in the regulatory framework. As a result, this has become one of the most complex areas of Medicare compliance and is the source of much confusion.
In order to shed light on this complex issue, a detailed overview has been drafted by the AAN, with the goal of helping members identify situations in which the Stark law might be implicated, as well as clarifying those situations where Stark is probably not an issue.
Note: The document is not a substitute for legal advice, and we recommend that Academy members consult with legal counsel with respect to their specific arrangements.