Documentation of the steps you take to determine commercial reasonableness is important. Carefully document conversations and research/data surrounding the decision. Keep supporting documentation with the contract. In the event that you are audited, you will need to demonstrate that commercial reasonableness was carefully considered along with FMV. Types of documentation that have helped in commercial reasonableness audits include:
- Information and statistics about the hospital and the surrounding community that indicate the appropriateness of the position under consideration
- Benchmarks from published market data or other surveys
- Analytical reports that document difficulties in meeting hospital obligations or quality initiatives that cannot be met without the proposed resources
- Meeting minutes
- Email threads
- Memos between negotiating parties
Commercial reasonableness is just as important as fair market value when documenting contracts for compliance. Although a ‘gut check’ is a good place to start, documentation of market rates and organization needs is key to a strong compliance program. Commercial reasonableness doesn't have to be a mystery; using tools like MD Ranger's percent paying tables and carefully analyzing physician payments will help solve even the most difficult situations.
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