Stark Law and Anti-Kickback Pitfalls in Ancillary Service Arrangements
Ancillary services — imaging, laboratory work, physical therapy, durable medical equipment, infusion, pathology — are often the most profitable lines in a medical practice or hospital system. They're also where compliance risk concentrates most heavily. The Stark Law (Physician Self-Referral Law) and the federal Anti-Kickback Statute (AKS) were written with exactly these arrangements in mind, and enforcement agencies have shown no hesitation about pursuing organizations that get the structure wrong — even when everyone involved believed they were acting in good faith. For hospital administrators and physician groups building or expanding ancillary service lines, understanding where these two statutes diverge — and where they overlap — is the difference between a compliant revenue stream and a False Claims Act exposure sitting quietly on the books until an audit, a departing employee, or a whistleblower brings it to light. Two Statutes, Two Different Tests Stark Law is a strict l...