HLT 520-Topic 4 DQ2
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Grand Canyon University *
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Course
520
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Medicine
Date
Apr 3, 2024
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docx
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Uploaded by LieutenantDonkey3004
Your hospital is looking at hiring a physician for the emergency room. Someone reported that this physician receives payment from a medical imaging company for each referral he sends to them. Is this a violation of the Stark law. Explain. What steps would you take as the hospital administrator to investigate and ensure you make the best decision for your hospital?
If a physician received payment from a medical imaging company for each referral he sent to them, yes, it is a violation of the Stark Law. Basically, the Stark Law, also known as the Physician Self-Referral Law, and it was created to avoid physicians gain any financial or any type of benefits by referral patients to the medical services where physicians or an immediate family member would benefit financially (Medical Staff Briefing, 2020). As a hospital administrator to ensure the accountability and liability of the physician, first of all, if possible the
person reported this matter needed to provide evidences of this complaint, the hospital has the SOP (standard of procedure) to follow to investigate this case before the physician could be hired. Or the physician may asked to provide evidences to proof his innocent.
Reference:
Medical Staff Briefing. (2020). Breaking down the Stark Law and Anti-Kickback Statute. 30(2), 1–5. https://eds-s-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?
vid=1&sid=68a5dd47-acb7-4a7b-a920-6537eaf1f523%40redis
This scenario could go both ways when it comes to the Stark Law. At first, I do believe that this is a violation of the Stark Law because the physician has an alternative reason for why they are bringing people into the medical imaging company. I would have to look at the patients the physician is bringing in because if each patient genuinely has a need to get imaging done, then they are not breaking the law. However, if there is even one patient that does not have a valid reason to get imaging done, then it is breaking the law. This is because they are sending people to the imaging center just to bring money for themselves. The steps I would take would be to double check the patients they are bringing in to make sure they are needed. If there is a patient that comes in without reason to have imaging done, I would make sure that steps were taken to have a meeting with the physician, a corrective action meeting. During this meeting I would go over what happened, what the expectations are, how they were broken, and what will happen if they occur again. The stark law states that a physician cannot receive compensation for referring patients (Medical Staff Briefing, 2020). As a hospital administrator it is my job to make sure the patients are getting high quality care while also making sure that all employees and patients stay safe. This is important to double check because if someone is referred just for compensation, it will hurt the credibility of the hospital.
Medical Staff Briefing. (2020). Breaking Down the Stark Law and Anti-Kicking Statute.30(2), 1-
5. https://eds-p-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?
vid=6&sid=6163f603-28c9-422a-91fc-24dee4142141%40redis
The Stark law is a law that prohibits physicians from making patient referrals to receive a form of healthcare service that is payable to Medicaid or Medicare, from entities in which the physician has a financial relationship unless it is one of the exceptions (Breaking down the Stark Law and Anti-Kickback Statute, 2020). The exceptions to the Stark law are if the physician is renting out office space or renting equipment there then it would not be in violation of the Stark law. In the scenario above, before determining the physician receiving a payment from the medical imagining company is or is not a violation of the Stark law, we must investigate. The first step would be finding out from the physician and the medical imaging if there is a contract between the two parties, if the physician is renting space, if the physician is renting equipment there, or if there are any other exceptions to the Stark laws that the physician may be apart of. If the physician is not violating the Stark Laws and qualifies for the emergency room position then the physician is hirable. If the physician is violating the Stark law then the physician would not considered hirable for the emergency room. The Stark law was put in place to prevent fraud and abuse. The hospital can not risk hiring anyone committing fraud and abuse.
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