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Essay Available:
Pages:
2 pages/≈550 words
Sources:
2 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Case Study
Language:
English (U.S.)
Document:
MS Word
Date:
Total cost:
$ 8.64
Topic:

False Claims ACT

Case Study Instructions:

Two physicians, Dr. S. and Dr. V., leased a nuclear camera so they would no longer have to refer their patients to the local hospital for nuclear imaging. Faced with the prospect of losing over a third of its $2,274,094 in annual gross nuclear medicine revenues, the hospital responded by threatening to revoke the doctors’ admitting privileges. Lengthy negotiations ensued, at the end of which the hospital agreed to sublease the camera from the two physicians; the camera remained at the physicians’ offices but other physicians with privileges at the hospital could use it. Four other local physicians who provided the same or similar services to patients as Dr. S. and Dr. V. brought a qui tam action alleging that the sublease violated the Anti-Kickback and Stark Acts and that the defendants falsely certified compliance with those laws in connection with claims submitted to Medicare in violation of the False Claims Act. 
(Please note: This is an actual court case and an Internet search may uncover the actual case details. You are prohibited from utilizing any source materials associated with this case. Use of any related materials will result in a reduction of points on this assignment. This assignment is being graded on your ability to critically think—on your own recognizance—based on your comprehension of the knowledge provided in this week’s learning materials.)
Instructions: Carefully review Chapter 7 of your textbook and research Stark Law. Given this scenario, analyze whether the actions of Dr. S. and Dr. V. violated Stark Law. Provide solid evidence supporting your decision by utilizing information from the Ashford University Library as well as the law itself. 
Your paper must be two to three pages in length, excluding the title and reference pages; include at least two scholarly sources, in addition to the textbook; and be written in APA format. 

Case Study Sample Content Preview:

Stark Law
Student’s Name
Institutional Affiliation
Stark Law
Introduction
The Stark law is a regulation of the medical practice that controls physician’s self-referral for Medicare or Medicaid patients (Satiani, 2006). Self-referral means the physicians are referring patients to a medical facility that he may or has interest financially i.e. through ownership, with compensation arrangement or investment. The law alleges a conflict of interest, whereby the physician is set to benefit from the plan. The law covers various health services such as laboratory tests imaging services, radiation treatment hospital services and medical devices and supply (Satiani, 2006). The Stark law is a fraud and abuse law, and it provides a complete ban on any Medicare or Medicaid payments and severe penalties have been placed on any arrangement considered to be a part of the scheme. The case of Dr. S and Dr. V should be analyzed under the anti-kickback statute, and other health care acts.
The Anti-kickback Statute
An anti-kickback statute is an act that provides criminal penalties to persons who knowingly and willfully offer, pay or receive remuneration to induce business payable by Medicare or Medicaid (Morrison, 2000).
The Case
The two physicians, Dr. S, and Dr. V, acted as a physician’s organization and thus they were able to obtain the camera legally. But the hospital after paying for the sublease of the camera violated the Stark law. This is because, the amount they paid for the sub-lease of the camera were inclusive of the amounts that they were to loose in the annual nuclear medicine revenues. The hospital thus was knowingly making the arrangement to refer its patients to the camera owned by the two physicians even though they knew they had had a financial interest in it. The hospi...
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