STARK BASIC TRAINING - The American Health Lawyers Association

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FAIR MARKET VALUE • Value in arm’s length transaction, result of bona fide bargaining between parties not in a position to refer to one another • Special rules for rental property • Value for general commercial purposes, not taking into account intended use • Not adjusted to reflect proximity to physician lessor • See definition at §411.351. 55 FAIR MARKET VALUE • Documentation • Use of appraisals prudent, but not mandated • Any appropriate commercially reasonable methodology • Ultimately, a facts and circumstances test • Nature of transaction • Location • Other factors 56 28
FMV RESOURCES • Phase I (pp. 944-45) • Phase II (p. 16107) • Phase III (pp. 51015-16) • Not advisory opinions! 57 COMPENSATION EXCEPTIONS • Rentals of space & equipment • Personal services arrangements, employment • Employment • Non-monetary compensation (within limits) • Medical staff incidental benefits • Recruitment and retention • Indirect compensation arrangements • Fair market value • Electronic health records donations • More 58 29
Page 1 and 2: STARK BASIC TRAINING Health Care Co
Page 3 and 4: THE SOLUTION: MULTIPLE STATUTES •
Page 5 and 6: WHAT’S NOT PROHIBITED • Physici
Page 7 and 8: THREE QUESTIONS 1. Is there a refer
Page 9 and 10: IMPUTED REFERRALS • Consulting ph
Page 11 and 12: WHAT’S NOT A REFERRAL • Request
Page 13 and 14: DESIGNATED HEALTH SERVICES (Not eve
Page 15 and 16: RESOURCES • 1877(h)(6); 411.351
Page 17 and 18: ENTITY • Multiple DHS entities ca
Page 19 and 20: DIRECT DOCTOR DHS ENTITY (No interv
Page 21 and 22: ICA EXCEPTION • Compensation must
Page 23 and 24: “STAND IN THE SHOES” Physician
Page 25 and 26: RESOURCES • 1877(a)(2), (h)(1)
Page 27: “SERVICE-BASED” EXCEPTIONS •
Page 31 and 32: GROUP PRACTICE CRITERIA • Group p
Page 33 and 34: GROUP PRACTICE CRITERIA • Share o
Page 35 and 36: 69 IN-OFFICE ANCILLARY SERVICES EXC
Page 37 and 38: IOAS EXCEPTION Where Are Services P
Page 39 and 40: IOAS EXCEPTION How Are Services Bil
Page 41 and 42: RECRUITMENT • Payments made to in
Page 43 and 44: PSA EXCEPTION • Arrangement is se
Page 45 and 46: RENTAL EXCEPTIONS • Lease is in w
Page 47 and 48: EMPLOYMENT EXCEPTION • Employment
Page 49 and 50: Non-Monetary Compensation Exception
Page 51 and 52: NON-MONETARY COMPENSATION EXCEPTION
Page 53 and 54: MEDICAL STAFF INCIDENTAL BENEFITS E
Page 55 and 56: TIPS • Always draw a diagram •

STARK BASIC TRAINING - The American Health Lawyers Association

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