Stark & Anti-Kickback Compliance

Compliatric is designed to simplify Stark & Anti-Kickback regulations, offering a comprehensive suite of tools to ensure your organization remains compliant.

Stark Law Compliance with Compliatric

Cultivate Stark Law compliance effortlessly with Compliatric. Our integrated modules empower healthcare organizations to document ownership interests, determine fair market value, and track designated health services.

Physicians Self-Referral Law (Stark Law):

Compliatric’s monitoring tools help prevent inadvertent referrals by tracking and reporting on physician relationships with entities, ensuring compliance with Stark Law.

Compliatric assists in documenting and managing ownership or investment interests to ensure they meet the Stark Law exceptions.

Compliatric’s HR integrations and Employee Management module help organizations structure employment arrangements to meet the Stark Law’s employment exceptions.

Compliatric’s financial transparency and reporting features assist in determining and documenting fair market value for physician compensation.

Compliatric’s integrated modules enable tracking of designated health services provided within physicians’ practices, ensuring compliance with this Stark Law exception.

Anti Kick-Back Transaction and Contract Management

Our platform streamlines documentation and oversight, safeguarding against unlawful inducements and promoting ethical healthcare practices.

Prohibition Against Kickbacks and Rebates

Compliatric’s monitoring tools identify and flag potential kickback or rebate issues, helping organizations avoid violations of the Anti-Kickback Statute.

Compliatric’s vendor management and contract management features help ensure that personal services and management contracts comply with Anti-Kickback Statute requirements.

Compliatric’s vendor management tools assist organizations in managing relationships with Group Purchasing Organizations and ensuring compliant discount arrangements.

Compliatric’s financial transparency and reporting features help organizations manage and document discounts provided by drug manufacturers, ensuring compliance with Anti-Kickback Statute provisions.

Anti-Kickback Program and Policy Compliance

Ensure adherence to Anti-Kickback regulations effortlessly with Compliatric’s program and policy compliance tools.

Safe Harbors

Compliatric helps organizations adhere to Anti-Kickback Statute safe harbors by providing structured, compliant frameworks for payment and business practices.

Compliatric’s integrated EHR solutions help organizations navigate the complexities of the Electronic Health Records Safe Harbor under the Anti-Kickback Statute.

Compliatric’s compliance tracking features assist organizations in managing warranties provided by manufacturers and suppliers, ensuring compliance with Anti-Kickback Statute provisions.

Compliatric’s comprehensive policy management and monitoring tools help organizations establish and maintain compliant patient assistance programs.

Compliatric’s vendor management features assist organizations in managing pharmacy waivers related to beneficiary cost-sharing amounts, ensuring compliance with Anti-Kickback Statute provisions.

Stark & Anti-Kickback Glossary

We’ve compiled a glossary of important Stark and Anti-Kickback related terms to help you on your compliance journey!

Stark Law

Also known as the Physician Self-Referral Law, the Stark Law prohibits physicians from referring Medicare patients for certain designated health services to entities with which the physician or an immediate family member has a financial relationship, unless an exception applies.

Anti-Kickback Statute

The Anti-Kickback Statute prohibits the exchange of anything of value in return for referrals for services covered by federal healthcare programs, such as Medicare and Medicaid. It aims to prevent fraud and abuse in federal healthcare programs.

Designated Health Services (DHS)

Under the Stark Law, designated health services include clinical laboratory services, physical therapy, occupational therapy, radiology, durable medical equipment, and other specified services.

Financial Relationship

In the context of Stark Law compliance, a financial relationship refers to any ownership or investment interest, or a compensation arrangement, between a physician (or an immediate family member) and an entity to which the physician refers patients for designated health services.

Fair Market Value (FMV)

Fair market value is the price that an asset would sell for on the open market under normal conditions, without any undue pressure to buy or sell. Determining FMV is crucial for ensuring compliance with Stark Law regulations regarding physician compensation.

Remuneration

Any payment, gift, benefit, or compensation provided to a person or entity in exchange for referrals or business generated through federal healthcare programs is considered remuneration. The Anti-Kickback Statute prohibits remuneration that could induce referrals.

Safe Harbor Regulations

Safe harbor regulations provide protection from prosecution under the Anti-Kickback Statute for certain types of business arrangements and financial relationships that meet specified criteria. Compliance with safe harbor regulations can help mitigate the risk of violating the Anti-Kickback Statute.

Exclusion

Exclusion refers to the process of excluding individuals or entities from participation in federal healthcare programs, such as Medicare and Medicaid, due to criminal convictions, license revocation, or other factors. Excluded individuals or entities are prohibited from receiving payment for services provided to program beneficiaries.

Compliance Program

A compliance program is a structured set of policies, procedures, and processes implemented by healthcare organizations to ensure adherence to applicable laws, regulations, and ethical standards. Compliance programs aim to prevent fraud, abuse, and other violations.

Advisory Opinion

An advisory opinion is a formal written opinion issued by the Office of Inspector General (OIG) or other regulatory agencies in response to specific inquiries regarding the application of healthcare laws and regulations to particular situations. Advisory opinions provide guidance on compliance issues and help healthcare providers understand their legal obligations.

Frequently Asked Questions

What is the Stark Law, and how does it impact healthcare providers?

The Stark Law, also known as the Physician Self-Referral Law, prohibits physicians from referring Medicare patients for certain designated health services to entities with which they have a financial relationship, unless an exception applies. Healthcare providers must comply with Stark Law regulations to avoid penalties for improper referrals.

The Anti-Kickback Statute prohibits the exchange of anything of value in return for referrals for services covered by federal healthcare programs, such as Medicare and Medicaid. It aims to prevent fraud and abuse in federal healthcare programs by prohibiting kickbacks, bribes, and other forms of remuneration in exchange for patient referrals.

Financial relationships that could violate the Stark Law include ownership or investment interests in healthcare entities to which a physician refers patients, as well as compensation arrangements, such as salary bonuses or rental agreements, between physicians and referring entities.

Healthcare providers can ensure compliance with Stark and Anti-Kickback regulations by implementing robust compliance programs, conducting regular training for staff, documenting financial arrangements, and seeking legal guidance when structuring business relationships that involve referrals for designated health services.

Safe Harbor regulations provide protection from prosecution under the Anti-Kickback Statute for certain types of business arrangements and financial relationships that meet specified criteria. Compliance with Safe Harbor regulations can help mitigate the risk of violating the Anti-Kickback Statute by providing a legally recognized framework for structuring business transactions.

Non-compliance with Stark and Anti-Kickback laws can result in severe penalties, including civil monetary penalties, exclusion from participation in federal healthcare programs, fines, and potential criminal prosecution. Healthcare providers must take compliance seriously to avoid costly legal repercussions.

Compliatric offers a comprehensive suite of compliance management tools and features designed to help healthcare organizations navigate complex regulatory requirements, including those related to Stark and Anti-Kickback compliance. From automated exclusion checking to robust policy management and incident reporting, Compliatric provides the necessary tools to streamline compliance efforts and mitigate regulatory risks.