Which law prohibits physician referrals where there is a financial relationship that could influence referrals?

• A. HIPAA
• B. False Claims Act
• C. Stark Law
• D. Anti-Kickback Statute

Answer: (C)

Stark Law specifically targets physician self-referral arrangements. It forbids referrals for designated health services when the physician or a family member has a financial relationship with the entity receiving the referral, unless there is an applicable exception. The aim is to prevent financial ties from influencing medical decisions and to curb overutilization in Medicare and Medicaid. It is a strict liability civil statute, so violations can lead to penalties, repayment of funds, and potential exclusion from federal programs, regardless of whether there was intent to commit wrongdoing.

In contrast, HIPAA concerns patient privacy and data security; the False Claims Act deals with submitting false or fraudulent claims for payment; and the Anti-Kickback Statute bans exchanging incentives to induce referrals but is broader in scope and requires proof of intent to commit wrongdoing and applies to a wider range of arrangements. The question’s focus on prohibiting physician referrals due to a financial relationship aligns most directly with Stark Law.