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Can A Doctor Be Charged With A Crime For Violating The Stark Law?


There are strict rules and regulations in place regarding how physicians and other health care providers bill federal health programs, including Medicare and Medicaid. Under 42 U.S.C. § 1395nn—or as it is more commonly known the “Stark Law”—physician self-referrals are largely prohibited. What happens if a doctor violates the Stark Law? The short answer is that they can face very serious civil penalties. However, while the Stark Law itself is a civil statute, it could be part of the basis of a criminal case. Within this article, our Orlando criminal defense lawyer for doctors provides a more comprehensive overview of key points to understand about Stark law cases.

The Stark Law: Know the Basics 

The Stark Law is one of the most important regulations in the healthcare industry. Simply explained, the federal law stops doctors from referring patients to places—labs, imaging centers, etc—where they have a financial interest. The Stark Law applies to all federal health dollars, including Medicare and Medicaid. The rule aims to keep patient care decisions based on health needs, and not the financial interests of a doctor. If doctors do not follow this law, they can face serious penalties.

Stark Law Violations: A Civil Offense 

Many Stark Law violations start as civil matters. A doctor could be fined or even suspended from Medicare/Medicaid for a Stark Law violation. Indeed, the Stark Law itself—meaning 42 U.S.C. § 1395nn—is a civil statute. In other words, there is now a crime called a “Stark Law offense.” Stark law violations are civil legal issues. Of course, they can be very serious civil legal issues. A doctor could face steep fines and potentially even disqualification for providing services through federal health programs (Medicare, Medicaid, etc). Further, a Stark Law violation could potentially be part of the basis for other criminal charges.

Crimes that May Be Filed Related to Stark Law Violations 

While the Stark Law itself results in civil penalties, certain actions related to its violations may lead to criminal charges under other laws. Here are crimes that may be filed in connection with Stark Law violations:

  • Health Care Fraud: Deliberately submitting false claims to federal health programs for financial gain is health care fraud.
  • Conspiracy to Commit Health Care Fraud: Agreeing with others to engage in activities that defraud health care programs is a crime regardless of whether or not the fraud was ever actually carried out.
  • False Claims Act Violations: Knowingly presenting or causing to be presented false claims for payment to the government is a criminal offense.

Contact Our Orlando Criminal Defense Attorney for Doctors Today

At The Baez Law Firm, our Orlando criminal defense lawyer protects the rights and interests of doctors. If you are a physician with any questions about Stark Law violations, please do not hesitate to contact us today for a strictly confidential consultation. With a law office in Orlando, we provide criminal defense representation to doctors in Orange County and all across Central Florida.

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