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Considerations for Determining Fair Market Value Physician Compensation Under Stark’s Final Rules
February 24, 2021
On January 19, long-awaited adjustments to the Centers for Medicare and Medicaid Services’ (“CMS”) Physician Self-Referral Law (commonly referred to as the “Stark Law”) and the Department of Health and Human Services Office of Inspector General’s (“OIG”) Anti-Kickback Statute (“AKS”) took effect that make it easier for hospitals and health systems to transition from volume to value-based care.[1]
This article focuses more specifically on the changes made to the Stark Law, and how organizations should be thinking about establishing fair market value (“FMV”) for physician compensation under the new regulations. Although there are some important differences between guidance under the Stark law and AKS, it is important to note that CMS and the OIG coordinated efforts in their regulatory updates, both providing a consistent message in their support for the “Regulatory Sprint to Coordinated Care.”[2]
Together, the new regulatory guidance provides important information that should be considered when establishing physician compensation. The most pertinent topics include new definitions for FMV, clarifications related to the value or volume guidelines, insight related to survey reliance, and what to consider when paying for quality outcomes.