C10131 Medical Science : Federal Healthcare Programs
For this Discussion, review the resources for this week and consider how Stark and anti-kickback statutes contribute to a health services organization’s policies for health services delivery. Think about safe harbors and how these relate to health services organizations.
Post a description of Stark and anti-kickback statutes for compliance within your health services organization. Then, describe what statutes you might address from compliance perspective as a current or future healthcare administration leader. Be specific and provide examples. Explain how your efforts to comply with these statutes address safe harbors and be specific about their relevance for your health services organization.
Answer:
Introduction:
The “Anti-Kickback Statute” is a federal criminal statute that prevents the offer of exchange of anything related to value. This federal criminal statute is an initiative to prevent referral coming from the federal health care program in exchange of money. Anti-Kickback Statute established penalty for the people or organizations who promote such act of crime on return of money. Criminal penalty per kickback ranges up to $25,000 along with five long years of confinement in jail. Moreover, civil penalties range up to $50,000, per kickback. It also claims thrice the price of damage sustained by the US government. The violators of the federal statute are excluded from the existing federal healthcare programs (Adashi & Kocher, 2015).
Stark Law can be defined as a set of federal laws existing in United States. This set of laws prevents the self-referral by the physician from Medicare. It also prevents referral via a Medicaid patient to an entity that is providing a designated health services (DHS). The act of crime is considered to be significant if the physician or the family member who is referring has a strong financial relation with the referred entity (Pope, 2012).
For safe harbor of these two above mentioned statute I as a future health care administrator will ensure that the doctors provide only referral for the better of the patient diagnosis while clearly stating the reason of referral and how it might help the patient. In this way I can understand the importance and authentication of the referral and can judge whether it is done in exchange of money or the patient genuinely needs this for proper treatment (Pope, 2012).
References
Adashi, E. Y., & Kocher, R. P. (2015). Physician self-referral: Regulation by exceptions. Jama, 313(5), 457-458.
Pope, T. M. (2012). Physicians and safe harbor legal immunity. Annals Health L., 21, 121.
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