Understanding fair market value is critical for compliance under Stark Law and Anti-Kickback Statutes, The National Law Review reported Oct. 20.
Compensation arrangements like employment, independent contractor, medical directorships, exclusive service arrangements, call coverage, quality reviews and medical staff officer stipends are required to be representative of fair market value.
Fair market value opinions are often based on benchmark data, but in the Stark Law Final Rules, CMS said that fair market value should include the application of both market area issues and physician-specific issues.
Commercial reasonableness, which includes whether application of benchmark factors are defensible, is a separate concept than fair market value.
When drawing contracts, physicians need to view both fair market value and commercial reasonableness as if advocating in front of a governmental entity, according to The National Law Review. If the contract is required to be defended, the analysis will need to include references and attachments to all documentation.