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Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity.
A person may need a referral from a primary care doctor to access some of the services that Medicare covers. Various parts of Medicare have different rules about referrals.
A 2007 study found that a patient being cared for by a physician who practiced self-referral for imaging studies was 1.196 to 3.228 times more likely to have an imaging study done as compared to a patient being cared for by a physician who did not practice self-referral. [4]
Lyndon B. Johnson signing the Medicare amendment (July 30, 1965). Former president Harry S. Truman (seated) and his wife, Bess, are on the far right.. Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. [7]
Who is eligible for Medicare? Experts explain the rules, including who may be able to get benefits before 65. Margie Zable Fisher. September 25, 2023 at 12:22 PM. Getty Images.
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...
The Anti-Kickback Statute [1] (AKS) is an American federal law prohibiting financial payments or incentives for referring patients or generating federal healthcare business. . The law, codified at 42 U.S. Code § 1320a–7b(b), [2] imposes criminal and, particularly in association with the federal False Claims Act, civil liability on those who knowingly and willfully offer, solicit, receive ...
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