The Stark law is a strict liability statute against a health care a hoax and abuse of the law that bans doctors from referring patients to facilities outside the hospital they are receiving care in which the doctors’ benefit from financially for selected Medicare-covered services such as MRI and CT scans. The rationale behind the statute is that when doctors have the liberty to refer patients to facilities in which they have a financial. Affiliation with, the viability and medical necessity of the referral is highly at risk of compromise and overutilization of the liberty would undermine the efficiency of health care (Stark Law, 2013). The stark law can be violated without intention, and at times the medical practitioners are responding to a need in health care that would otherwise be unsatisfied.
Dr.S and Dr.V in the case study did violate the Stark law by renting their nuclear camera to the hospital they were physicians so that their patient would use it instead of being referred to the local hospital for imaging. The doctors would gain financially from the lease of the nuclear camera, and the local hospital which was offering the services would lose substantial Medicaid revenues due to the reduced number of patients. The violation was however unintentional since to the doctors they were aiding in easing the process for the patients. They were offering a need that was unmet at their hospital; thus the conflict in the breach of Stark Laws.
Patients have rights in health care providers that the health care system and the practitioners are expected to uphold and deliver. One of the rights of patients in health care provision is the right to availability/convenience health care (Thornton et al., 2017). Patient satisfaction is also a major preference and legal provision for patients. Availability of health care means that patients do not have to strain and struggle to access the type of health care they need, In fact, health care systems primary aim is to promote accessibility in health care at the patient’s convenience as much as possible. Healthcare providers are expected to promote and advance the right of patients in the course of medical practice and health care delivery. Dr. S and Dr. V play the role of making health care more accessible, available and convenient to the patients at the hospital. They reduce the strain of the patients having to go to the local hospital for imaging and then come back to the hospital with the results for further diagnosis and treatment. Therefore, Dr. S and Dr. V are promoting the patient’s right to accessible and convenient care by leasing their nuclear camera to the hospital where they work even though they are violating stark law.
Federal and statutory laws apply in this case study such as the False Claims Act and the anti-kickback statute. The anti-kickback statutory law regards transactions in the health care of services that are covered by the state health programs. It bans individuals from intentionally and knowingly benefiting from referrals they make to other people to receive services or care that is covered by Medicaid or Medicare (American Bar Association, 2014). The false claims act relates to holding liable individuals or organizations that deceive federal programs to the public. In the Dr. S and Dr. V case, the anti-kickback law is infringed upon as the doctors would benefit from the leasing the nuclear camera and the imaging is a service that is covered by Medicare. False claims act is also infringed upon since leasing the imaging services to the patient’s cuts of the hospital revenues from the local hospital for nuclear services.
The case of Dr. S and Dr. V requires the determination of whether the doctors and the hospital needed to consult the Stark law and whether there was a threat to their admitting privileges. The doctors’ act of leasing their camera to the hospital was infringed the stark law since they would benefit financially by referring patients for imaging with a machine they owned and from which they were getting returns. However, looking at the intentions and the situation at the hospital, the doctors’ actions make are viable. The intention of the doctors was not primarily them benefiting from the leasing but from making health care provision more convenient for the patient and the hospital they worked for. The intention was justifiable but the stark law is a strict liability law, and thus the doctors would have to argue for their case strongly using counselors with health care expertise and knowledge of the stark law to be able to exploit the principles and support their position. The defending advocates need to defend Dr. S and Dr. V against the accusations of violating the Stark law by adequately exploring the intentions of the doctors and the capacity of their act to meet a need that the hospital did not meet. Also, the fact that leasing the equipment to the hospital makes health care at the hospital more convenient for the patients promote the primary objectives of health care and thus should count as a defense argument to justify the Stark law. With the stark law being such as a strict statute, the doctors need to be very strategic in their defense since there is a clear violation of the Stark law, but they can mitigate the consequences through a knowledgeable and strategic defense counsel.
Thornton, R. D., Nurse, N., Snavely, L., Hackett-Zahler, S., Frank, K., & DiTomasso, R. A. (2017). Influences on patient satisfaction in healthcare centers: a semi-quantitative study over 5 years. BMC health services research, 17(1), 361. doi:10.1186/s12913-017-2307-z
Stark Law.org (2013). Stark law. Retrieved on 6 March 2019 from http://starklaw.org/stark_law.htm
American Bar Association (2017). What Is the Anti-Kickback Statute? Retrieved on 6 March 2019 from https://www.americanbar.org/groups/young_lawyers/publications/tyl/topics/health-law/what-is-anti-kickback-statute/