In this program, we will review the physician anti-referral laws (Stark I and II), provide an in-depth discussion of physician employment contracting, review the relevant Stark exceptions and discuss how physician compensation models can be in compliance with the Stark prohibitions.
This session is designed for health care executives, physicians and other health care providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare. Several recent cases bring home the realization that Stark II (the physician anti-referral law) is alive, still with us and as viable as ever, and it can be used as the basis of a False Claims Act action.
As a health care executive, physician or other health care provider, you should be very concerned about the potential for Stark II, as well as the Anti-Kickback Statute, being used as the basis for an action brought under the Federal False Claims Act. In this seminar, you will learn about the elements of the Stark II law, along with the various exceptions and safe harbors that you can rely on for protection against enforcement under this law.
This is important because under recently enacted health care laws, enforcement and health care fraud task forces have been greatly enhanced. Recovery under the Federal False Claims Act last year resulted in over $4.9 billion being recovered for the federal government, $24.2 billion since the law was revised to make it more relator friendly in 1986.
Since 1986, whistleblowers have been awarded nearly $4 billion. Whistleblowers are where a majority of the Federal False Claims Act suits originate. Two cases involving Stark, the Toumey Health System case in South Carolina, with a settlement in excess of $72 million (after a verdict of $237.5 million) and the Hardeman Memorial Hospital case in Texas, with a settlement of $398, 230.56.
In the Toumey
case, the CEO agreed to pay $ 1 million and be excluded from federal
programs for four years. In Hardeman, the Texas federal court sentenced
former CEO Angela Edwards to 2 ½ years in prison and ordered her to pay
$370,657 in restitution. If that is not enough to get your attention,
consider the recent cases finding that the "responsible corporate
officer doctrine" allows the government to hold hospital CEOs and others
directly responsible for the fraud.
You will want to attend this seminar to learn how to protect yourself and your organization.