Reducing Patient Leakage by Directing Physician Referrals, AKS Safe Harbors, and Stark Law Exceptions

Description

Many healthcare systems are experiencing patient leakage when patients choose out-of-network providers over those in network. As a result, the healthcare systems are losing substantial revenue. This often occurs because physicians refer patients for out-the-network services.

Many hospitals or healthcare systems do not include provisions in their physician contracts that would require that the physicians only refer their patients for in-network services (directed referral requirements). This is often because the hospitals or healthcare systems are concerned about Stark violations or that such requirements would (or would appear to) interfere with the doctors' medical judgment.

Hospital and healthcare system leadership and counsel need to understand when and how to use directed referral requirements to combat patient leakage and the value-based safe harbors to the federal and state anti-kickback statutes and exceptions to the Stark Law to incentivize physicians to achieve health outcomes for a patient population.

Listen as our authoritative panel of healthcare attorneys examines whether and how healthcare systems currently use directed referral requirements. The panel will also address how directed referral requirements can be implemented in compliance with the Stark Law. The panel will offer best practices for healthcare systems interested in using, monitoring, and enforcing directed referral requirements. The panel will also address safe harbors to the AKS and exceptions to the Stark Law to incentivize physicians to achieve health outcomes.