Under the Stark Law, which scenario is described as prohibited?

Under the Stark Law, which scenario is described as prohibited?

• A. Referring patients to get lab testing done at the lab owned by their spouse
• B. Referring patients to a lab with no ownership interest
• C. Referring patients for necessary services only
• D. Referring patients to out-of-network providers when covered by insurance

Answer: (A)

Under Stark Law, a physician must not refer patients for designated health services to an entity with which the physician or their immediate family has a financial relationship, such as ownership or investment, unless an exception applies. A lab owned by the physician’s spouse creates that financial relationship, so referring patients there is prohibited. If the lab has no ownership interest, there is no financial relationship, so the referral would not violate Stark. The key factor is the existence of a financial relationship, not just whether the service is necessary or whether the provider is out-of-network.

Under Stark Law, a physician must not refer patients for designated health services to an entity with which the physician or their immediate family has a financial relationship, such as ownership or investment, unless an exception applies. A lab owned by the physician’s spouse creates that financial relationship, so referring patients there is prohibited. If the lab has no ownership interest, there is no financial relationship, so the referral would not violate Stark. The key factor is the existence of a financial relationship, not just whether the service is necessary or whether the provider is out-of-network.