Impact of Stark II Rules on interventional pain practices

The original Stark Law, commonly referred to as "Stark I," was enacted in 1989. Stark I prohibited a physician from ordering a clinical laboratory test or service from an entity with which the physician, or an immediate family member, had a financial relationship if the test or service was reimbursable by Medicare, unless an exception to the law applies. The Stark Law was amended in 1993. The amendments are commonly referred to as "Stark II." Stark II extended the referral prohibition to services reimbursable under Medicaid and greatly expanded the list of items and services covered by the law i.e., "designated health services." HCFA published phase I of the Final Stark Rules on January 4, 2001. These rules dealt with referral definition issues, volume or value of referrals, in-office ancillary services exception, group practice definition, and definitions of designated health services. This article describes phase I of Stark II Final Rules, and its impact on interventional pain medicine practices.