Inpatient and Outpatient Hospital Services Designated health services include all inpatient and outpatient hospital services. Therefore, every physician who is on staff at a hospital, unless the physician is inactive, refers patients to the hospital for inpatient and outpatient services. Therefore, no physician on the medical staff of a hospital is exempt from the law's scope - any transaction the hospital does with any physician on staff must be vigorously scrutinized. Most troublesome to us is that the Stark Law's prohibitions are absolute. If the law is implicated, an exception must apply or the arrangement is illegal.
Intent is irrelevant.
The element of knowledge or scienter plays no role. There is no consideration of motive. No room for judgment. No margin of error. The law is a strict liability statute and the penalties are severe.