White Paper No. 1: Rolling Up Our Sleeves: A Stark Law Refresher

In our first white paper, we set the stage for the balance of the series, and provide a high-level refresher on the Stark Law’s architecture and address a handful of changes—some minor, some more significant—that the Final Rule makes to the Stark Law’s most basic building blocks, including the definitions of “physician,” “referral” and “designated health services.”

White Paper No. 2: Separating the Wheat from the Chaff: Technical Requirements, Low-Dollar Violations, and Payment Discrepancies

In our second white paper, we cover several important changes CMS made in an effort to reduce the universe of arrangements that, while not implicating any of the Stark Law’s principal policy objectives, nevertheless violate its referral and billing prohibitions.

White Paper No. 3: Key Standards (Part I): The “Volume or Value” Standard

White paper number three covers what is arguable the Stark Law’s key substantive requirement, the so-called “volume or value” standard (Volume/Value Standard).

White Paper No. 4: Key Standards (Part II): “Fair Market Value” and “Commercial Reasonableness” Standards, and Indirect Compensation Arrangements

This white paper covers the Final Rule’s impact on the second and third key substantive standards: specifically, whether the compensation at issue is consistent with “fair market value” (FMV Standard), and whether the arrangement is “commercially reasonable” (Commercial Reasonableness Standard). This white paper also addresses the significant changes the Final Rule made to the definition of an “indirect compensation arrangement” (ICA), the most complicated of the Stark Law’s four categories of financial relationships.

White Paper No 5: New Wine in Old Bottles: Providing Greater Flexibility Under Existing Exceptions

In our fifth white paper, we address changes made in the Final Rule to nine Stark Law exceptions. Eight of these exceptions focus on the exchange of remuneration in specific types of compensation arrangements. Some of these exceptions include: Space Rental Exception, Equipment Rental Exception, FMV Exception, and Recruitment Exception.

White Paper No 6: What’s Past is Prologue: Technology Subsidies Part Deux

This white paper address changes made in the Final Rule to update, clarify and expand the electronic health records exception (EHR Exception) and create a new exception for donations of cybersecurity technology and services (Cybersecurity Exception).

White Paper No 7: The Problem of the Square Peg and the Round Hole: when Fee for Service and Managed Care Collide

In our last white paper of the series, we address three new exceptions created by CMS for certain so-called “value-based” compensation arrangements between physicians and entities that furnish designated health services (DHS Entities): The exception for arrangements with value-based full financial risk (Full Financial Risk Exception), the exception for value-based arrangements with meaningful downside financial risk to the physician (Meaningful Downside Financial Risk Exception), and the exception for value-based arrangements more generally (Value-Based Arrangement Exception).