This checklist, which was created by Anne Novick Branan, appeared in HCCA’s Healthcare Compliance Forms and Tools.[1]
Stark Law Compliance Checklist for Employee Arrangement Exception
[COMPANY NAME]
Stark Law Compliance Checklist
Employee Arrangement Exception
Name of the Agreement: |
_____________________________ |
Other Party(ies) to the Agreement: |
_____________________________ and _____________________________ |
Effective Date: |
_____________________________ |
Termination Date: |
_____________________________ |
Other Contracts with this Party(ies): |
_____________________________ |
Name of the Agreement(s): _____________________________ Party(ies) to the Agreement: _________________________ and _____________________________ Effective Date: ________________________ Termination Date: _____________________ | |
*Meets Stark Exception (circle): |
Yes or No |
INITIAL REVIEWER: _____________________________ DATE: ___________
FINAL REVIEWER: ______________________________ DATE: ___________
Stark Law Compliance Checklist
Employee Arrangement Exception
Requirements of Employee Arrangement Exception |
Satisfied |
Not Satisfied |
Explanation |
---|---|---|---|
Each agreement is in writing and the physician is a bona fide employee of organization (i.e., receives a W-2). | |||
Each agreement is signed by all parties. | |||
Agreement specifies the identifiable services covered by the arrangement and compensation over the term of the agreement. | |||
Arrangement(s) cover all the services to be furnished by the physician (or immediate family member of the physician) to the entity. Condition is met if:
| |||
Aggregate services contracted do not exceed those that are reasonable and necessary for the legitimate business purpose of the arrangement(s), and the services furnished would be commercially reasonable even if no referrals were made to the employer. | |||
Compensation is consistent with fair market value (FMV). | |||
Compensation is not determined in a manner that takes into account directly or indirectly the volume or value of any referrals or other business generated between the parties. | |||
The term of each arrangement is at least one year. If an arrangement is terminated during the term with or without cause, the parties may NOT enter into an agreement where the material terms of the arrangement are different than the material terms during the first year of the original term of the arrangement. | |||
Compensation is also based on a form of productivity bonus based on services performed personally by the employed physician. | |||
Arrangement does not otherwise violate the federal Anti-Kickback Statute. | |||
Arrangement does not violate any federal or state law or regulation governing billing or claims submission (i.e., rules on reassignment of reimbursement). | |||
Services to be furnished under each arrangement do not involve counseling or promotion of an activity or business arrangement that violates any state or federal law or regulation. |
Indirect Compensation Arrangement |
Satisfied |
Not Satisfied |
Explanation |
---|---|---|---|
|
Directed Referrals |
Satisfied |
Not Satisfied |
Explanation |
---|---|---|---|
If compensation is conditioned on the physician’s referrals to a particular provider, practitioner, or supplier:
|
Notes:
-
The checklist only applies to compensation (i.e., remuneration) made in accordance with the identified arrangement, but does not consider any other types of remuneration (i.e., items of value) that may be involved between the parties (i.e., monetary or non-monetary).
-
The arrangement is considered to be in compliance with the Anti-Kickback Statute if all checklist items are satisfied and there are no other overriding financial arrangements (i.e., improper “Stacking Agreements”) that would necessarily implicate the Anti-Kickback Statute.