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Resources
CMS’s Stark Web Page - Includes general background on the Stark Law, Advisory Opinions (the few and the proud), and practical information such as the current CPT Code listings for certain categories of DHS and the CPI-U updates for the non-monetary compensation and medical staff incidental benefits exceptions.

Major Stark rulemakings in the Federal Register - annotated

Federal Self-Referral Law - from BNA's Health Law and Business Series - selected updates

​     • Self-Referral Disclosure Protocol
     • Final Disclosure Requirements - hospital relationships and in-office ancillary services exception

Report on Medicare Compliance – selected articles by Nina Youngstrom

     • Fourth Circuit Opinion in Tuomey Healthcare—Quite a Fix for Stark Junkies!
     • Council for Urological Interests case
     • Period of Disallowance; Ohio Valley & Campbell cases
     • Halifax case
     • Under arrangement and lease changes

Anti-Markup Rule (42 C.F.R. §414.50)

     • Final 2009 rulemaking - Preamble discussion begins at p.69799.
     • BNA Portfolio update (Web version)
     • Implications for Anatomic Pathology - article with Brad Tully
     • Anatomic Pathology—Revisited - with Brad and published by the Physician Organizations Practice Group of
        the American Health Lawyers Association as part of its Diagnostic Testing Legal Issues Toolkit

Health and Human Services Office of Inspector General (OIG) Web Site. OIG has primary civil administrative and enforcement authority with respect to the Anti-Kickback Statute (42 U.S.C. §1320a-7b(b)), the Civil Monetary Penalties Law (42 U.S.C. §1320a-7a), and Exclusion of providers from Federal Health Care Programs (42 U.S.C. §1320a-7). Its Web site contains a wealth of compliance and fraud and abuse resources, including the recent HEAT provider compliance training.

United States Code - When all else fails, look to the statute.:-)

Social Security Act - The Medicare provisions are in Title XVIII and the Medicaid provisions in Title XIX. The agencies often cite to the SSA instead of the U.S. Code. For example, the Stark Law appears in Section 1877 of the SSA, but is codified at 42 U.S.C. §1395nn.

Electronic Code of Federal Regulations - unofficial, but most current - Stark regulations begin at 42 C.F.R. §411.350 

Code of Federal Regulations - official

MedPAC Reports

     • Improving payment accuracy and appropriate use of ancillary services (June 2011, Chap. 2)
     • Addressing the growth of ancillary services in physician offices (June 2010, Chap. 8)
     • Impact of physician self-referral on use of imaging services (June 2009, Chap. 4)
     • Issues in physician payment policy (March 2005, Chap. 3)

Government Printing Office

Library of Congress - legislative materials






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