The Stark Statute: Parsed, Probed and Panned

Alice takes on an in depth untangling of confounding issues under the Stark statute in The Stark Statute: Parsed, Probed and Panned -- from whether it even works, to such basics as the definitions of referral, a consultation, and a group practice, none of which is actually straightforward. She moves on to the quagmires of supervision where the law sweeps into its ambit the issues of personal supervision, direct supervision and incident to—used without reference to their long-standing presence in Medicare prior to Stark.  Shifting to pure financial issues, she  addresses the distinctions between fair market value vs. commercially reasonable vs. the fair market value exception. Additional nuance arises with respect to the differences among indirect compensation arrangements vs. under arrangements vs. stand in the shoes concepts, as well as shared facilities by contrast with timeshare arrangements.  She also considers permitted directed referrals vs value-based arrangements. She ends with a consideration of the dilemma created by how the drafters addressed Medicaid. She chose these specific issues, which are hardly all that can be said about this travesty of a statute, because the law is both vague and ambiguous on these points.