Stark Statute

Serving Clients Nationwide

The purpose of the Stark Statute is to reduce the questionable overutilization of medical services encouraged by certain financial arrangements between service providers and referring physicians. To achieve this purpose, the Stark Statute prohibits hospitals or other medical service providers from billing Medicare for items or services provided based on a referral from a physician with whom the provider has a financial relationship. Originally passed in 1989 to cover laboratory services, the Stark Statute has since been amended to cover nearly every type of medical service, therapy, or medical item.

Stark Statute and Medicare Fraud

Stark violations are a type of Medicare fraud because they represent cases in which a physician’s financial incentive to refer patients may compromise his or her professional judgment on whether the particular treatment is necessary. This means that claims submitted based on those referrals are medically suspect and therefore fraudulent.

There are exceptions for physicians under bona fide employment contracts with the provider as well as other particular transactions. However, for any financial relationship to be compliant with Stark, it must be well-documented, involve fair market value compensation for services rendered, and not be based on the number of referrals the physician makes.

Becoming a Whistleblower on Stark Violations

Both the Stark Statute and the Anti-Kickback Statute allow individuals with knowledge of violations of these statutes to report them in the form of a qui tam lawsuit. These whistleblowers act on behalf of the government and the public, recovering taxpayer dollars and protecting patients from physicians whose financial interests have compromised their professional ethics and judgment.

To encourage whistleblowers to come forward, successful qui tam plaintiffs are entitled to generous whistleblower rewards which can amount to a significant percentage of the funds recovered for the government.

If you have knowledge of a Stark Statute violation, you can become a whistleblower with the help of the qui tam attorneys at Kenney & McCafferty, a public interest law firm representing whistleblowers nationwide for over fifteen years. Kenney & McCafferty’s attorneys deal almost exclusively with qui tam cases, ensuring you the strongest whistleblower protection possible under the law. Kenney & McCafferty is a high-profile qui tam law firm that has participated in some of the largest recoveries in the history of the False Claims Act.

If you have knowledge of a fraud or false claim against the government, please contact our qui tam lawyers today. Kenney & McCafferty attorneys will consult with you about your case, without obligation. All communications with Kenney & McCafferty attorneys during these consultation services are confidential and protected by the attorney-client privilege.