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APPENDICES: Physician Compensation Issue/Compliance Check List

Parties
  • Physician
  • Immediate family member of physician
  • Healthcare facility or entity
  • Related entities
  • Person receiving (directly or indirectly) funds from state or federal health care program
Term of the Agreement
  • Minimum of one year
  • Is there a termination without cause provision?
  • Is there an evergreen clause?
  • Is there automatic amendment / termination in case of change in law / enforcement action?
Description of Services
  • All the services provided by the parties must be specified in the agreement
Aggregate Services
  • Agreement should address all of the services provided by the parties to each other; or
  • Cross reference other agreements for services between the parties (including immediate family members and closely related entities)
Commercially Reasonable
  • Amount of services should not exceed what is necessary to meet the commercially reasonable business needs of the parties
Compensation
  • Aggregate compensation set in advance
  • Compensation formula set in advance
  • Total compensation not in excess of fair market value
  • Not based on volume or value of referrals for designated health services
  • If the entity is tax exempt, and the physician is a "disqualified person," has the procedure to establish the intermediate sanctions fair market value presumption been followed?
Referrals
  • Are there referrals between the parties?
  • Evidence of intent to induce referrals?
  • Requirement (directly or indirectly) to make referrals?
  • Does arrangement contemplate referrals to entity owned by one of the parties or a related entity?
  • Are referrals for designated health services?
  • Are referrals for services paid for (in whole or part) by state or federal healthcare program?
Billing Practices
  • Who will provide billing services?
  • Have proper assignment forms been completed?
  • If Medicare reassignment is occurring, is an exception met?
  • Is there potential for double B&O tax?
  • How is billing service compensated?
Compliance Plans
  • Do one or both parties have a compliance plan?
  • Does either party need a compliance plan?
  • Are there methods for physician's to ensure proper coding?
Ownership Interests
  • Set at fair market value?
  • Distributions proportionate to interest?
  • Control proportionate to interest?