Speakers: Robert Wade, Partner at Krieg DeVault, Rud Blumentritt, Partner at Horne LLP
While most of us understand the risks associated with the Stark Law and the Anti-Kickback Statute, and if you don’t, we have your back. There are always cases that are in the grey areas or are just downright complicated.
While at the American Health Lawyers Association Annual Meeting, I attended a session geared toward just the problem of handling complex fair market value and commercial reasonableness issues.
There are three different perspectives to looking at fair market value:
- The bystander approach
- The professional appraiser approach
- The legal and regulatory approach
With any approach, it is important to consider the specific market conditions in your area for the specific specialty in question. For example, it may be necessary, and reasonable, for your organization to pay at the higher end of the market range for anesthesiology based on the localized supply of physicians, however that does not mean that it is necessarily reasonable to pay at the higher end of the market range for gastroenterology.
When documenting FMV, it is also a best practice to document the commercial reasonableness of paying for the position in the first place. MD Ranger helps our subscribers get an idea for whether is is commercially reasonable to pay for a service through our Percent of Subscribers Who Report Paying for a Service and Paid Administrative Position Count tables. While commercial reasonableness is subjective, having benchmarks to inform your decision can help to justify paying, or not paying.
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