Which of the following scenarios could lead to additional civil penalties under Stark law?

The scenario that could lead to additional civil penalties under Stark law involves circumventing a prohibited referral arrangement. Stark law is a set of federal regulations designed to prevent physician self-referral, where physicians may refer patients to facilities or services in which they have a financial interest. This law aims to protect patients from conflicts of interest that could affect their care.

Circumventing a prohibited referral arrangement directly violates the intentions of Stark law, as it implies that a physician is attempting to bypass established regulations to benefit financially from referrals that are not compliant. Such actions can result in severe penalties, including civil fines and exclusion from federal health programs like Medicare and Medicaid.

In contrast, referring patients to a hospital for convenience does not inherently violate Stark law unless there is an undisclosed financial interest involved. Failing to comply with practice standards and not reporting a referral to the state could lead to other regulatory issues but are not specifically tied to the Stark law's prohibitions and penalties. Thus, while those situations are serious, they do not have the same direct link to civil penalties as circumventing a prohibited referral arrangement.