Indlela uMthetho we-Stark ochaphazela ngayo izigulane
Xa kuziwa kwimithetho enxulumene nokunakekelwa kwempilo, enye yeyona mithetho ebaluleke kakhulu kwaye ibonakala nzima kunayo yonke into ekuyiqondayo nguMthetho weStark. Ebizwa emva koxhaswa ngumthetho, ummeli wase-US uPet Stark waseCalifornia, lo mthetho uyaziwa nangokuthi ngumthetho ogqithisileyo.
Ekuqaleni, uMthetho we-Stark wenzelwe ukuthintela oogqirha ekubhekiseleleni kwiiMedare neeMedicaid kwiimvavanyo ezongezelelweyo okanye iinkonzo zamatyala ukuba ugqirha (okanye isihlobo sogqirha) wayenomdla kwiinkampani ezenza iimvavanyo.
Ixhalaba kukuba oogqirha babenokukwazi ukuhlaziya iimvavanyo, okanye iinkonzo zempilo ezikhethiweyo (DHS), ukuba zimi ukufumana imali kwiimvavanyo ezongeziweyo.
Ezinye zeenkonzo zempilo ezikhethiweyo ezibhekiselele kuMthetho we-Stark zibandakanya: iinkonzo zelabhu zonyango, unyango lwamaziko , unyango lwe-radiology, i-radiology kunye nokubonelela ngempahla, izixhobo zonyango ezizinzileyo kunye nezinto eziphathekayo, ii-prosthetics, orthotics , iinkonzo zempilo yasemakhaya, iinkonzo zempilo yokuthetha, izibonelelo zesibhedlele ezingenasifo , kunye neenkonzo zesebhedlele ezingaphandle. Ukuba izigulane zifuna ezi nkonzo, oogqirha abanako ukuzithumela kumaziko apho abanomdla.
Imingeni yoMthetho we-Stark uhamba
Ukususela ekuqaleni kwayo ngo-1989, uMthetho we-Stark uhlaziywe kwaye wanda. Ukuhlaziywa, okwenzeka phakathi kuka-1992 no-2007, ngokuqhelekileyo kuthiwa nguStark I, uStark II no-Stark III. Ngenxa yoko, umthetho sele ude kakhulu kwaye ukuthobela umthetho kuye kwaba ngumngeni kumagqirha.
Ngaphezu koko, umthetho we-Stark ngumthetho ojongene nobunzima. Oko kuthetha ukuthini ukuba injongo yegqirha ayinakucingwa xa ihlolisisa ukuhanjiswa. Ngenxa yoko, ugqirha unokufunyanwa unetyala lokuphula umthetho ngaphandle kokufuna ukwenza njalo.
Ngaphantsi komthetho we-Stark, Ukuba ugqirha wenza ukuthunyelwa kwaye akukho mithetho yecala edibeneyo, ngoko umthetho we-Stark uphulwe.
Kwaye oku kunokuba kubi kakhulu. Enyanisweni, oogqirha banakho ukuhlawuliswa ukuya kuma-25,000 amawaka ngokuphulaphula kunye nokuphindwe kathathu inani elifunwa kwi-Medicare.
Ezinye iimbali zingabandakanya ukufunwa imali yonke imali efunyenweyo kwiinkonzo, i-$ 100,000 isohlwayo somntu ngokuzama ukukhupha umthetho kunye nokukhutshwa kwiinkqubo zempilo zonyango. Oogqirha banokuhlangabezana noxanduva olongezelelweyo phantsi kwe-Federal Federal Claims Act. Umthetho we-Federal False Claims, obizwa ngokuba nguLincoln Law, ngumthetho wesigqeba owamisela abantu okanye iinkampani eziphanga iinkqubo zikaRhulumente ezifana ne-Medicare. Esi senzo sisisiseko sikaRhulumente sokulwa nobuqhetseba kuorhulumente.
Abagxeki be-Stark Law bathi ugqirha ogqithisiweyo kumaziko aseburhulumenteni awunasasazeka. Ngaphezu koko, bathi abo oogqirha abanabo okanye abatyala imali kwiindawo zonyango bayasabela kwisidingo ebantwini abangazange bahlangane noko. Baya kugcina ukuba amaziko asebenza ngamagqirha aphindwa ngamaxesha amaninzi.
Injongo yoMthetho weStark
Umthetho woqobo wawungelula kwaye uchanekileyo. Injongo yalo yayikukuvalela ugqirha we-DHS xa isigulane sagqitywa yi-Medicare okanye omnye umhlawuli karhulumente.
Ukucinga kukuba ugqirha ukuzithumela kubonisa ukungqubuzana komdla kuba ugqirha uyazuza kwiindawo zabo zokuthumela.
Ngenxa yoko, abaninzi abaxhasa iStark Law bakholelwa ukuba ngaphandle kwayo, oogqirha banokubandakanya ukusetyenziswa kweenkonzo ezininzi. Lo mkhuba uza kuqhuba iindleko zokunakekelwa kwezempilo. Ngaphezu koko, bakholelwa ukuba bekuya kudala inkqubo yokudlulisela ekuthunjweni enokuthi ibonakalise ukhuphiswano ngabanye banikezeli.
Kukho nkxalabo yokuba ngaphandle koMthetho we-Stark, ukwenziwa kwezigqibo zonyango kuya kugxininisa kwizigulana ezihambayo kwiimvavanyo ezithile kunye nezibonelelo kunokuba ufake kuqala isiguli kunye neemfuno zakhe.
Oku bekuya kubonakalisa ukonakalisa izigqibo zonyango ezenziwe kwaye zibeke izigulane engozini.
Indlela uMthetho we-Stark ochaphazela ngayo izigulane
Ngomthetho we-Stark okhoyo, abaninzi abaxhasayo bakholelwa ukuba kugcina oogqirha bengalawuli iimvavanyo ezingadingekile . Ukongezelela, bathetha ukunceda ukugcina iindleko zokunakekelwa kwempilo ekukhuleni okungenasidingo nasekukhuthazeni ukhuphiswano ngokudambisa ukuxhaphaza kwiinkonzo. Kwakhona kuqinisekisa ukuba izigqibo zokunakekelwa kwezempilo azichaphazelekanga ukuba kungenzeka ukuba ugqirha uza kuxhamla kuvavanyo olongezelelweyo.
Ngakolunye uhlangothi, abagxeki banenkxalabo yokuba ukuba isigulane siphila kwindawo encinci kwaye sifuna iimvavanyo ezizodwa ezi zinto zingazibeka kwindawo engalunganga ngakumbi ukuba ukhetho olulodwa luncedo lugqirha. Kwiimeko ezifana nalezi, isigulane sinokufunwa ukuqhuba iikhilomitha ezide ukufumana uvavanyo ngenxa yokuba ugqirha akakwazi ukumthumela kwisibonelelo sabantu ngenxa yokuba ugqirha unomdla kuloo mali. Ingakumbi, ukuba isiguli asinakho ukuthutha okanye imali yokuqhuba enye indawo, akanakuze afumane unyango lwempilo alufunayo. Ngenxa yoko, uMthetho we-Stark unokubeka ezinye izigulane zisengozini yokungafumani unyango olufanelekileyo lwezempilo.
Ukongezelela, abagxekayo banenkxalabo yokuba uMthetho we-Stark uvimba ukuhlaziywa. Ngomnye umzekelo owaziswa phambi kweCongress, iqela lezokwelapha lalifuna ukubonelela abacebisi bezityalo ezizimeleyo kwiiofisi zezilwanyana zangasese. Aba bacebisi baza kuthethwa xa ugqirha efumanisa ukuba umntwana uza kufelwa ekuzalweni okanye kungekudala. Nangona inkonzo yayiya kubaxhamla izigulane ngokunika iimpendulo ezongezelelweyo kunye nokuvavanywa, phantsi koMthetho we-Stark abacebisi baza kuthathwa njengenzuzo kumcebisi wecala.
ILizwi
Ngokubanzi imbono yasekuqaleni yomthetho we-Stark yayikukhusela izigulane ze-Medicare ukuba zithatyathwe ngabagqirha abanokuma bazuze ekuthungeni ukuhlolwa. Kodwa ngazo zonke iinguqu kunye nokuguqulwa komthetho we-Stark, kuye kwaba nzima ukuba oogqirha bazi ukuba ngaba baphula umthetho. Enyanisweni, kukho iinombolo zeefemu zomthetho ezigqityiweyo ekuqeqesheni oogqirha malunga noMthetho weStark. Kwaye kukho ukhetho oogqirha abangakwaziyo ukuphula uMthetho we-Stark.
Ngakolunye uhlangothi, kukho oogqirha abayaziyo uMthetho we-Stark kwaye ukhetha ukungakuhoyi. Ukuba uziva ukuba ugqirha wakho uyalela ukuba ahlole iimvavanyo kuba uya kubaxhamla kwiimali, unokuqhagamshelana ne-Ofisi yoMhloli-Jikelele kwiSebe lezeMpilo kunye neeNkonzo zoLuntu eMelika (800) ii-HHS-TIPS okanye (800) 447-8477.
> Imithombo:
> "Umgaqo weNdlela yabaFundi abatsha: Ukunyenga kunye nemithetho yokuhlukumeza." ISebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu. https://oig.hhs.gov/compliance/physician-education/01laws.asp
> Betheze, uFilipu. "Ngokukhawuleza, ixesha lokulungisa uMthetho we-Stark," iiNkokeli zezeMpilo, uNgove-10, 2016. Http://www.healthleadersmedia.com/leadership/quick-time-fix-stark-law
> Ellison, Ayla. "Izinto ezili-15 zokumazi malunga nomthetho osisigxina," u-Becker Hospital Hospital Review, ngoFebruwari 18, 2017. https://www.beckershospitalreview.com/legal-regulatory-ssues/15-things-to-know-stark- 021717.html
> Gosfield JD, Alice. IQiniso eliQinisekile Ngomthetho we-Stark, "i-American Academy ye-Family Physicians, ngoDisemba 2003. http://www.aafp.org/fpm/2003/1100/p27.html
> Higashi DC, uStephanie. "Ukungaziboni Akunalo Isizathu: Musa ukuhlukumeza iMithetho ye-Stark," i-Chiropractic Economics, ngoFebruwari 15, 2017. https://www.chiroeco.com/violate-stark-laws/
> "Ugqirha Wokuzimela." Amaziko e-Medicare kunye neeNkonzo zeMedicaid. https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/index.html