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Dr. Thompson is a neurologist who provides care in Mainstreet, Indiana. She owns her own practice, but costs to maintain her MRI equipment are increasing. She is considering using space at St. Vincent Hospital and sending patients that require MRI or other imaging procedures to St. Vincent’s radiology department. Her longtime friend, whom she met in medical school, is the CEO of St. Vincent’s and told her she can use the space for free for a while until her practice recovers. Stark Law
Does Dr. Thompson have a financial relationship with St. Vincent Hospital?
Answer: Yes. Although there is no actual money changing hands here, St. Vincent’s is giving, and Dr. Thompson is receiving, something of value (i.e., free rent). This creates a direct financial relationship.
Does Dr. Thompson refer patients to St. Vincent Hospital? Stark Law
What if Dr. Thompson does not see Medicare or Medicaid patients?
Answer: This could reduce the chance that Dr. Thompson will violate the Stark Law. However, the issue is not whether Dr. Thompson sees Medicare or Medicaid patients, but that she refers those patients to an entity with which she has a financial relationship. If she truly turns Medicare and Medicaid patients away prior to treating them, and does not refer them to St. Vincent’s, then she may be in compliance. Note that it is not advisable to rely on not treating Medicare or Medicaid patients because it is possible to have a claim slip through.
Do you think Dr. Thompson has violated the Stark Law? Why?
How would you fix this?