Developing your contracts and fair market value: Spidey sense for compliance officers, Part 1

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The first time I was asked to review a contract while working in compliance, I was mortified! I had never read a contract, nor did I know what I was even looking for. I’m sure I’m not the only one to have encountered this situation, but it wasn’t a pleasant memory. I very well could have missed something that typically compliance is supposed to catch. Which, in hindsight, is a liability.

To get myself out of the situation of not knowing what I was doing, over the years, I attended as many webinars and conference sessions as I could that related to contracts and fair market value (FMV). It seems that every year, there is at least one session on FMV and/or contracts at the Health Care Compliance Association Compliance Institute.

As great as those sessions are (I have yet to walk away disappointed), one thing has escaped each presentation I’ve attended, and that is, as a compliance officer, how do I know what to look for? These conference and webinar presentations are often done by a lawyer, looking at it from a lawyer’s perspective, which means it is very “legal.” They tell me what safe harbor or exception may apply in various situations and how to ensure the safe harbor or exception standards are met. These sessions have always been a gold mine of information and “how to” regarding Anti-Kickback Statute (AKS) and Stark, but what about from the compliance officer’s perspective—not from a legal standpoint? How does one know when something needs to go to legal for further analysis? That is what I want to discuss, is when you, a compliance officer, are sitting in a meeting and someone say something about a contract, how do you know if it needs a deeper dive or if it is fine to continue through to signature? Or, if you are reading a contract, how do you know what might stand out as an issue? To that end, I present how to develop your contracts and FMV “Spidey sense.”

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