One of the biggest mistakes radiology practice marketers
make when it comes to adhering to the requirements of the Stark Law, which
prohibits Medicare and Medicaid patient referrals to entities that the
referring physician has a financial relationship with, is believing that
intentions matter, says Adrienne Dresevic, Esq., founding partner of the
Southfied, Mich., firm The Health Law Partners, P.C.
Dresevic and Clinton Mikel, Esq., another partner in the
firm, are experts on the many technical requirements of the laws that govern
relationships between provider entities and referring physicians. They advise radiology
and other specialty groups and have found that while few marketers ever set out
to intentionally violate the law, this is of no help when a mistake is made.
“Stark is a strict liability law so intent doesn’t matter,” Dresevic
says. “The law is technical in nature so you can have the best intentions in
the world and it really doesn’t matter. All the claims submitted connected with
[the violation] are tainted.”
For example, a hypothetical practice might want to help
patients who are struggling to cover their co-pays. The practice tells their
referring physicians that they are waiving co-pays for Medicare and Medicaid patients.
While nice, this is a violation of the law as it would create an incentive for
those physician to refer all of their Medicare and Medicaid patients to that
Another common mistake is thinking the law does not apply
because there is no financial relationship, but a financial relationship can be
triggered by even a small gift, like buying lunch for the physician’s office,
if rules are not followed closely, Dresevic says.
Likewise, Independent Diagnostic Testing Facilities that
provide mobile imaging services also may think the law does not apply to them
because they are not a hospital or physician group, but it does, Mikel says.
Dresevic and Mikel will be presenting on the requirements of
the Stark Laws and the Sunshine (Open Payments) Law at the Building Better Radiology Marketing Programs
conference in Fort Worth, Texas, on Monday, March 6. Their session will be in a
question and answer format and based on a webinar that RBMA members will have
the opportunity to watch online ahead of the conference.
Being able to list the key elements of the Stark and
Sunshine laws is something everyone on a marketing team needs to be able to do,
Mikel says. Although marketers themselves will not be financially penalized by
the government if the laws are violated, they need to understand the details of
the legal requirements and not leave adherence to the laws up to others in the
“Stark, the Sunshine Act and some of the tracking you need to
do for the technical requirements are fairly granular and the persons theoretically
overseeing the practice are not the ones doing the day-to-day work,” Mikel says.
“They are not doing the day-to-day allocations of how much was spent toward
marketing to a particular physician group. These are technical laws and yes the
entity will get in trouble if the marketer does not comply with the law, but it
is important for the marketer’s job to understand the parameters of dos and
don’ts so it doesn’t reach that point of a payment refund.”
In addition, while marketers themselves may not be
financially at risk for violating Stark and Sunshine laws, the government can
use its exclusion authority to get at a marketer who violates the laws.
To become better at navigating the many legal requirements
for marketers in a highly-regulated field like radiology, attend the Building
Better Radiology Marketing Programs conference. A special early-bird discount
is available until February 3.