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Stark Internal / External Practice Relationships

The Stark law affects physician practices -- including solo practice physicians and those practicing in physician-owned medical group practices -- in different ways depending on whether the financial and referral relationships are internal or external to the physician practice entity.

Where designated health services such as x-ray, physical therapy, outpatient prescription drugs or others are furnished and billed for through a physician’s medical practice entity, then the Stark law will apply to the these “within practice” or internal DHS financial and referral relationships within the physician practice organization.

The law also affects physician financial and referral relationships that are outside of or external to the physician’s own medical practice entity including lease and service arrangements established with hospitals and other DHS Entities, medical director and other relationships with organizations that are outside of the physician practice entity.

What do you want to do?

Focus your use of StarkCompliancePlus by based on whether you need information related to financial and referral relationships that are internal or external to a physician practice organization.

Internal Practice Relationships

  • Learn how to comply with the in-office ancillary services or physician services exceptions to enable a medical practice to furnish and receive reimbursement for ancillary services.
  • Understand the application of the Stark law’s compensation test to physicians and group practices. 
  • Learn about compensation plans and review examples of plans that are crafted to promote compliance with the Stark law’s compensation test. 
  • Explore how a group practice can develop new ancillary services that can be furnished by the practice.

External Practice Relationships

Specialty suites

Find information by topic or site of service.This suite provides subscribers with information on the Stark law's in-office ancillary services and physician services exceptions which allow physicians to make referrals for designated health services within their medical practice without violating the Stark law. Choose the specialty-specific practice area below for more information on how the Stark law affects that given specialty.

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