Stark's Take On Gifts To Referring Physicians

By Author: Jaun Paul
Total Articles: 53
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Do you stumble upon questions such as these?


Can you multiply the limit for a multi-physician practice?

What about front office staff?

Attorney Wayne Miller has the answers to these questions:


After attending a
healthcare management seminar recently, an
HC Compliance Essentials reader wrote, We have lots of questions about Stark, anti-kickback and gifts to referring physician.


Gifts to physicians who can potentially refer Medicare or Medicaid patients to your practice or health care body can run afoul of Stark and anti-kickback laws. Practice managers, apart from monitoring the financial arrangements between their office and physicians to whom they refer patients, should also be tracking all the gifts and benefits.


Your aim is to see to it that ...
... no referring physician receives more than the annual limit on referring physician gifts under Stark. The amount is subject to the Consumer Price Index increase every year. If your office surpasses the limit, you need to intimate this to CMS.


How much can you spend on referring physicians?


According to Miller, the annual maximum gift per person for 2009 is $355, with each gift prized at not more than $30. These maximums adjust annually based on CPI. Gifts should be totally voluntary and there should not be any expectation or solicitation for gifts to referring physicians. Additionally, gifts may be nonmonetary only.


Is it ok to give a gift for each referral?


According to Miller, it's a no-no. Gifts should not be made based on the volume or value of referrals. You just have to keep in mind the limit per person.


If there are five physicians in a practice can you multiply the $355 limit by five?


It depends on whether the gift is given to individual physicians or to the practice as a whole.


If gifts are showered on individual doctors, each would be subject to a separate $355 limit. The applicable Stark exception would not apply to giving a gift to a medical group rather than an individual. However it is recommended that groups be treated as one person.


But while giving gifts to groups, you need to be careful. Under Medicare and state


Anti kickback laws, gift giving is not sanctioned; as such it's critical that your gift policies do not reveal an intent to reward referrals.


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