Jane Pine Wood and Richard Cooper, both partners at McDonald Hopkins, generously sat down with us to share their expertise on healthcare compliance laws. Nearly half of the states in the nation have laws that limit the practitioner-laboratory relationship by regulating re-billing, and both federal and state governments have some form of anti-kickback, Stark, or Stark-like law on the books. Misconceptions abound regarding exactly who is and who is not under their jurisdiction. As Wood and Cooper explain, regulators are strict and penalties are severe, so it’s essential for all practitioners who work with labs to familiarize themselves with the laws that dictate these relationships.
Practitioners with Medicare Relationship
Any practitioner with Medicare, Medicaid, or CHAMPUS involvement has to deal directly with the Federal Stark Law and Anti-Kickback Laws. As Cooper explains, even if the financial arrangement doesn't relate to Medicare/Medicaid/CHAMPUS patients, “If there's a referral of those type of patients between the lab and the group, practitioners can still be tagged for federal law violations.”
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