Medicare Compliance & Reimbursement

Question: Does the HHS Office of Inspector General (OIG) issue advisory opinions on the Stark Law? Would I submit a request for an advisory opinion there?

New York Subscriber

Answer: No, OIG focuses on the Anti-Kickback Statute — not the Stark Law. “Opinions about the Stark law (section 1877 of the Social Security Act; also known as the ‘physician self-referral law’) come within the jurisdiction of the Centers for Medicare & Medicaid Services (CMS),” according to an OIG frequently asked question (FAQ) on advisory opinions.

“The Stark law and the Anti-Kickback Statute are separate statutes, and, depending on the facts, a particular arrangement might implicate one or both statutes,” says OIG. “The Stark law applies in the case of direct and indirect financial relationships with referring physicians (as further described in that law).”

And, “Although OIG is not authorized to issue opinions about the Stark law, our regulations require that a party requesting an OIG advisory opinion notify us if the party will be separately requesting a Stark opinion from CMS about the same arrangement,” the national watchdog advises.

Review the FAQ at https://oig.hhs.gov/faqs/advisory-opinions-faq.asp.