Which law prohibits a physician from referring Medicare patients to clinical laboratory services where they or a family member have a financial interest?

Prepare for the RHIA Reimbursement Test with multiple choice questions, each accompanied by hints and explanations. Ace your exam with confidence!

The Stark Law specifically addresses the issue of physician self-referral, particularly in the context of Medicare patients. It prohibits physicians from referring patients to clinical laboratories or other designated health services in which they or their immediate family members have a financial interest. This law aims to prevent conflicts of interest and ensure that medical decisions are made based on patient care needs rather than financial incentives. By limiting these referrals, the Stark Law seeks to protect patients and maintain the integrity of the healthcare system.

The other laws mentioned do tackle aspects of healthcare fraud and abuse but do not focus specifically on the issue of self-referral in the same manner as the Stark Law. The False Claims Act addresses false claims for payment submitted to government programs, while the Civil Monetary Penalties Act allows for penalties against individuals or entities for various forms of misconduct in healthcare. The Federal Antikickback Statute criminalizes the exchange of remuneration for referrals of services covered by government healthcare programs, but it is broader and does not specifically target the direct referral practices covered by the Stark Law.

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