News & Analysis as of

Physicians Fair Market Value

Dentons

Ep. 65 – Don’t Make This Mistake When Using Physician Compensation Benchmarks

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Physician compensation benchmarks like those from the Medical Group Management Association (MGMA) or the American Medical Group Associations) AMGA are commonly used in the healthcare industry. Organizations lean on them for...more

Foley & Lardner LLP

Let’s Talk Compliance: Physician Compensation Plans and Recent Trends in Physician Compensation 2024

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As part of our work with clients and preparing for Let’s Talk Compliance events, we often notice trends through the questions we receive. The following physician compensation compliance topics are currently trending....more

Husch Blackwell LLP

DOJ False Claims Act Suit Against Montana Oncologist Is a Warning Sign to Busy Physicians

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On August 26, 2024, the United States Attorney’s Office for the District of Montana filed a False Claims Act (FCA) complaint against a Montana oncologist, alleging that the oncologist’s busy schedule led to excessive claims...more

Holland & Hart LLP

FMV for Provider Contracts: Regulatory Standards

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As a general rule, healthcare employers are required to pay employed physicians and other contracted providers fair market value (FMV) for their services, but many employers do not understand relevant regulatory standards. ...more

Husch Blackwell LLP

How to Wear the Investor Hat When Physicians Are the Revenue Generators

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Engaging in management and investor conversations about maintaining and growing a business is critical, no matter the industry. Whether you’re discussing normal business sustainability, organic growth, or contemplating a...more

Mintz - Health Care Viewpoints

Violations for Excessive Physician Compensation

The Department of Justice (DOJ) recently filed a complaint against Erlanger Health System (Erlanger), a county-owned public health system, and two of its Tennessee hospitals alleging that the health system systemically...more

Lathrop GPM

Now is Not the Time to Relax: Record Settlements in Stark Law and False Claims Cases

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In early May 2024, the University of Pittsburgh Medical Center (UPMC) agreed to pay $38 million to resolve a False Claims Act case based on alleged Stark Law violations. The size of the settlement in United States ex rel. J....more

Dentons

Ep. 12 - Working with Valuation Experts to Substantiate Fair Market Value Compensation

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We often work with valuation experts to ensure compensation payments between healthcare organizations and physicians are fair market value and commercially reasonable for purposes of compliance with the Stark Law and the...more

Foley & Lardner LLP

“Let’s Talk Compliance”: Hot Topics in Compliance

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Editor’s Note: PYA and Foley & Lardner hosted the 6th Annual “Let’s Talk Compliance” two-day Virtual Conference on January 18 and 19, 2024. Panelists included Foley & Lardner attorneys and PYA experts. The event was hosted by...more

Tucker Arensberg, P.C.

False Claims Act (FCA) Liability for Physician Compensation Exceeding Fair Market Value (FMV)

When negotiating physician compensation issues, hospitals frequently rely upon the premise they must pay fair market value compensation in order to comply with the provisions of the Stark Act prohibiting referrals in exchange...more

Harris Beach Murtha PLLC

OIG Kickback Opinion: Referring Labs Providing Technical Component Services Implicate Anti-Kickback Statute

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This opinion addresses a proposed agreement (“Proposed Arrangement”) between a national anatomic pathology laboratory (“Requestor”) and laboratories owned in whole or in part by physicians who may refer (“Referring...more

Dickinson Wright

Tax Issues in Issuance or Repurchase of Equity in Physician and Other Practice Groups

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Adverse tax issues can arise for physicians and other professional practice groups interested in issuing equity to attract and retain junior physicians. If equity is issued at below fair market value, the new equity owner...more

Foley & Lardner LLP

Stark Law Changes: Hospitals Need to Revisit Physician Compensation Arrangements

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Based on recent changes and clarifications made by the Centers for Medicare and Medicaid Services (CMS) in the Federal Physician Self-Referral Law (commonly known as the “Stark Law”), hospitals and health systems need to...more

Health Care Compliance Association (HCCA)

[Webinar] Updates on Stark Regulations and Impacts on Fair Market Value/Commercial Reasonableness - June 28th, 12:00 pm - 1:30 pm...

Learning Objectives: - Impact 2021 Physician Fee Schedule has had/will have on Physician Compensation and Benchmark Data - Impact COVID has had/will have on Physician Compensation - Evolution of Use of Benchmark Data,...more

Health Care Compliance Association (HCCA)

[Event] Chicago Regional Healthcare Compliance Conference - October 22nd, Chicago, IL

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

Health Care Compliance Association (HCCA)

Goran Musinovic on Healthcare Real Estate Compliance

Goran Musinovic is Vice President of the Realty Trust Group in Knoxville and co-author with Michael Honeycutt and Gregory Gheen of the Chapter “Contracts with Referral Sources: Real Estate Compliance” in the new Health Care...more

Steptoe & Johnson PLLC

What to Expect, Part II: New Stark Law Definitions for Physician Compensation

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The Centers for Medicare & Medicaid Services’ (“CMS”) new final rule amending the implementing regulations of the Physician Self-Referral Law (“Stark Law”), in part, defines fundamental terms, such as “fair market value” and...more

White & Case LLP

Fraud and abuse risks in digital health: What tech companies need to know about healthcare enforcement – Part II

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For companies looking to monetize their hard-earned innovations in digital health, there is a minefield of potential healthcare enforcement to avoid. As discussed in Part I of this alert, such healthcare enforcement can lead...more

Foley & Lardner LLP

Key Takeaways from the Revised and Clarified Stark Law Regulations – Part 2

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CMS made impactful changes to the Federal physician self-referral law’s (i.e., Stark Law’s) regulations in its Final Rule that were effective January 19, 2021 (with the exception of the changes to 42 C.F.R. § 411.352(i) that...more

Jones Day

CMS Finalizes and Clarifies Key Valuation Terms in the Stark Law

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The Situation: Under the federal Physician Self-Referral Law ("Stark Law"), many physician arrangements must meet one or more of the so-called "big three" requirements: that the arrangement be "commercially reasonable," that...more

ArentFox Schiff

Changes to the Stark Law’s Special Rules on Compensation Create Flexibility and Reduce Confusion for Physicians and Other Health...

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In its recent Final Rule significantly revising the federal Physician Self-Referral Law (Stark Law), the Centers for Medicare and Medicaid Services (CMS) implements several important changes to the special rules on...more

Health Care Compliance Association (HCCA)

[Webinar] What Compliance Professionals Need to Know About the New Stark and Anti-Kickback Regulations - January 29th, 12:00 pm -...

Learning Objectives: - Explain changes to existing concepts including fair market value, commercial reasonableness, and volume or value - Examine the new definitions, exceptions, and safe harbors and their impact on...more

Verrill

The Regulatory Sprint is Over – What’s at the Finish Line Under the New Stark and AKS Final Rules?

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The U.S. Department of Health and Human Services (HHS) completed its “Regulatory Sprint” by finalizing changes to regulations pertaining to two federal fraud and abuse laws. On December 2, 2020, the Centers for Medicare &...more

Davis Wright Tremaine LLP

CMS Sprints to Overhaul Stark

With the benefit of more than three decades of rulemaking and hundreds of submissions under the Self-Referral Disclosure Protocol, CMS has seized the opportunity in the final Sprint Regulations to adopt a number of...more

Epstein Becker & Green

“Monetizing” the Value of Your Ownership in Your Practice: Critical Consideration #1 - Thought Leaders in Health Law Video Series

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Partnering with a private equity (PE) investor can help physicians monetize the value of their practice. Why treat your practice differently than other assets in your retirement portfolio? A PE transaction will provide an...more

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