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The hospital I work for just lost a lawsuit. I am concerned for my job. Is it possible the hospital will close?

Wednesday May 29, 2013
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Question:

Dear Nancy,

The hospital I work for just lost a lawsuit. A jury found them to be in violation of the Stark Law and the government is fining them more than $237 million dollars. I am concerned for my job and the next closest hospital is an hour away. Is it possible they will close the hospital?

Brittany



Nancy Brent replies:

Dear Brittany,

It sounds as though your employer is facing some rough times due to its violation of the Stark Law. Although a complete discussion of the law is beyond the scope of this column, some general comments can be made.

The Stark Law prohibits a physician from referring Medicare patients for specific health services to an entity in which the physician or an immediate family member has a financial relationship — some exceptions exist. In addition, the specific healthcare entity to which the referral took place cannot submit claims to Medicare for services resulting from the prohibited referral.

Civil penalties include monetary penalties and exclusion of the physician and any healthcare service where a prohibited referral took place from the Medicare and Medicaid programs, when the violation was a knowing one.

The closure of the hospital could occur if no physicians are on staff to care for patients due to their exclusion from Medicare and Medicaid programs. Likewise, if the facility was involved in a circumvention scheme, which is where physicians and/or an entity enter into agreements that have a goal to ensure referrals to an entity when it is in violation of the law, the facility could be fined and also excluded from Medicare and Medicaid programs. Not every patient is a Medicare or Medicaid patient, but such exclusions have serious ramifications for one's livelihood and for the continued existence of a healthcare delivery system.

You might want to explore other employment options as soon as you can, whether at the facility some miles away, or in another nursing role in your immediate community.

Sincerely,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.