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11/18/2021 2020 Part B Utilization Data Loaded
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EDITOR'S WELCOME

Reference and hospital laboratories often provide specimen collection items and supplies to customers free of charge. This week we will examine whether this practice complies with the Stark Self-Referral Prohibitions. As always, please feel free to forward comments, suggestions, or questions.

Sincerely,

Gregory B. Root

BACKGROUND: STARK II

The first Self-Referral Prohibitions (Stark I) prohibited physicians from referring specimens obtained from Medicare patients to clinical laboratories with which the physician or an immediate family member of the physician had a financial relationship. In addition, any clinical laboratory that received a Medicare referral from a physician with which it had a financial relationship, could not bill Medicare for the performance of that procedure. In 1995, Stark was expanded to prohibit self-referrals of not only lab services, but also many other designated health services. The expanded Physician Self-Referral prohibitions, now called Stark II, apply to Medicaid as well as Medicare referrals.

Physicians and designated health ....

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