False Claims Act
Prior to beginning work on this discussion, read Chapter 7 of the textbook and the article Stark and Anti-Kickback Laws Limit Lab-Marketing Methods, and review the web page Health Care Fraud News (Links to an external site.)Links to an external site., the website Stark Law (Links to an external site.)Links to an external site., and the handout The STARK Law. Then, review the following case study:
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 think critically—on your own recognizance—based on your comprehension of the knowledge provided in this week’s learning materials.)
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.
- Explain the legal parameters for patient rights and the role that Dr. S and Dr. V play in protecting those rights.
- Explain the federal, statutory, or case laws that apply in this scenario.
- Provide solid evidence supporting your decision by utilizing information from the Ashford University Library as well as the law itself.
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