The issue of internal compensation formulae leading to enforcement under Stark has been underscored again by a primary care practice in South Carolina paying
$2 million dollars in settlement for, in part, compensating their physicians a percentage of the value of laboratory and other claims they submitted to Medicare and TRICARE. The CEO and laboratory director agreed not to be involved in managing the practice for five years. The Stark rules are complicated; and their intersection with the anti-kickback statute and the anti-markup rules are complex. It is essential for every practicinvolved with Stark services to review their compensation formula with sophisticated counsel.