Understanding Stark Law (Physician Self-Referral Law) and Its Compliance Implications

Overview

This session provides a comprehensive overview of the Physician Self-Referral Law, commonly known as Stark II, along with its key exceptions and enforcement landscape. The Stark Law prohibits physicians from referring patients for certain designated health services payable by Medicare or Medicaid to an entity with which they—or their immediate family members—have a financial relationship, unless an exception applies.

The program will explain how noncompliance with Stark II can trigger violations under the False Claims Act (FCA) and expose healthcare organizations and physicians to severe penalties. It will also include an assessment of recent enforcement actions and case studies that highlight how providers can inadvertently violate Stark II.

Participants will gain a detailed understanding of what is prohibited under the Stark Law, how to correctly apply exceptions, and what criteria must be satisfied to remain compliant. The session will also review recent court decisions to illustrate how these rules are interpreted and enforced in real-world cases.

Why You Should Attend

This webinar is essential for healthcare executives, physicians, and compliance professionals involved in Medicare, Medicaid, or other federal healthcare programs such as TriCare. Recent cases have demonstrated that Stark Law violations are more common than many realize—and these violations can become the foundation for False Claims Act investigations and prosecutions.

Attending this session will help participants:

• Understand the fundamental principles and structure of the Stark II law

• Identify and apply the various exceptions that protect legitimate financial relationships

• Recognize the compliance risks that can lead to enforcement actions

• Learn from landmark cases such as Tuomey, which resulted in significant financial and professional consequences for both the organization and its leadership

This training emphasizes how the Affordable Care Act (ACA) expanded healthcare fraud enforcement and the importance of maintaining strict compliance with referral and compensation rules.

Participants will also explore how Stark Law aligns with American Medical Association (AMA) ethics rules governing physician referrals and how these principles translate into lawful business and clinical practices.

Areas Covered in the Session

• Overview of the Federal Physician Self-Referral Law (Stark II)

• Explanation of Designated Health Services (DHS) under the law

• Detailed review of exceptions and how to meet their specific criteria

• Understanding how Stark II violations can trigger FCA liability

• Analysis of recent Stark Law enforcement actions and case law

• Best practices for Stark Law compliance and internal oversight

Who Will Benefit

This webinar is ideal for professionals responsible for healthcare compliance, financial relationships, and physician arrangements, including:

• Hospital Executives (CEOs, COOs, CFOs, CNOs, CMOs)

• Physicians and Medical Directors

• Nursing Home Executives and Administrators

• Physician Practice Managers

• Compliance Officers and Legal Counsel

• Healthcare Executives and Consultants involved in Medicare or Medicaid billing

Key Takeaways

• Gain a clear understanding of Stark II and its implications

• Learn how to identify and apply lawful exceptions

• Understand how Stark Law violations can lead to False Claims Act exposure

• Review real-world case studies and enforcement trends

• Implement best practices to protect your organization from costly penalties