Comparison Chart of Anti-Kickback Safe Harbors and Stark Exceptions -- Referral Agreements for Specialty Services
Referral Agreements for Specialty Services – Current as of March 2021
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Stark |
Anti-Kickback |
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The agreement is for one party to refer a patient to the other party for the provision of a specialty service payable in whole or in part under Medicare or a State health care program in return for an agreement on the part of the other party to refer that patient back at a mutually agreed upon time or circumstance. |
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The mutually agreed upon time or circumstance for referring the patient back to the originating individual or entity is clinically appropriate. |
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The service for which the referral is made is not within the medical expertise of the referring individual or entity, but is within the special expertise of the other party receiving the referral. |
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The parties receive no payment from each other for the referral and do not share or split a global fee from any Federal health care program in connection with the referred patient. |
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Unless both parties belong to the same group practice, the only exchange of value between the parties is the remuneration the parties receive directly from third-party payors or the patient compensating the parties for the services they each have furnished to the patient. |