Stark Law prohibits referrals to facilities owned by physicians or their family when payment is made by which government programs?

• A. Medicare or Medicaid
• B. Private pay
• C. Workers' Compensation
• D. None of the above

Answer: (A)

Stark Law targets self-referral when the payment for designated health services comes from federal health care programs. The aim is to prevent physicians from profiting from referrals to facilities they own or have a financial interest in, when federal funds are involved. Medicare and Medicaid are federal health care programs, so when payment for the service is made by these programs, the self-referral restrictions apply. Private pay and workers’ compensation are not federal health care programs, so the Stark Law’s self-referral prohibition doesn’t automatically apply to those payment sources. In short, payments made by Medicare or Medicaid trigger the Stark Law restrictions, which is why Medicare or Medicaid is the correct context.