The Unsteady Hand of the Stark Act

From its inception in 1989 Stark (the Act), officially known as the Federal Physician Self-referral Law, has allowed an "ethical background" from which healthcare organization can build and maintain their own ethical regulations and protocols. In many ways, the Act has improved the quality of care available much in the way that antitrust laws have improved quality in the private business sector through the creation of competition. However, the Act is not without its own faults. For example, the Act basically covers Medicare issues in reference to financial relationships between physicians - their immediate family members - and the facilities which they refer Medicare patients (Gosfield, 2009).

This seems simple enough to understand, but many consider the Act to be outdated, very difficult to interpret, and follow (Sutton, 2011). Though the Act is written in very narrow and defined terms, difficulty is created due to its constant evolution and change. For this reason, many organizations have continued to create and apply their own version of the Act within their own organization. This has resulted in a general across the board "bench line" for each of employee of not accepting any freebies or kickbacks whatsoever from any vendor while under the employment of said employer. Sometimes even writing about the Act can be a bit of a mind twister!

This confusion has also led many to believe that the Act is also detrimental in many ways to the business of healthcare. As previously cited, the fear of violating the Act and as a result losing funding through Medicare and other government sources has created a tremendous fear amongst facilities. This, in turn, has created a very regimented business atmosphere that has significantly hurts a healthcare facility's ability to grow (Taylor, 1999).

Though the healthcare industry is not a business in the same sense as companies like Apple or Nike, it is still critical to remain as financially stable as possible. The Act like many other government regulations imposed on the healthcare industry has created a virtual mine field that organizations and administrators must navigate on a constant basis. Ethically, the Act has created a culture that strives to continually evolve ethically, but it should not stand in the way of creation, evolution, and ingenuity. If so, the healthcare industry at best will not perform to its abilities or at worst continually regress.

References:
Gosfield, A. (2009). Stark Law Covers a Narrow Corridor of Actions (Malpractice Consult). Medical Economics, 86(17), 38.

Sutton, P. (2011). The Stark Law in Retrospect. Annals of Health Law/Loyola University Chicago, School of Law, Institute for Health Law, 20(1), 15.

Taylor, M. (1999). Healthcare Struggles with Stark Reality. Modern Healthcare, 29(27), 30.