3. Above fair market value. Stark and AKS generally require referral practitioners to pay or be paid at fair value for goods or services provided, including payments made pursuant to employment contracts; Services agreements; Use of space, equipment or personnel Selling items (42 CFR no 411.357 (a) (d), (f), (i), (l), (p) and 1001.952 (b)-(d)). Unless there is a specific exception, it is likely that overpayments and underpayments will result in referrals and strong concerns and AKS. The regional court began its analysis by warning that “the writing requirement of the Stark Act is not a pure technique” and that “[t]he legal requirements of the exception must be proven at the time of each medical transfer in question.” In this context, the Landgericht formulated its investigation as follows: “The critical question is whether there are sufficient documents for the period between the expiry date of the agreements and the execution of the Addenda proving the course of the parties.” In accordance with the final rule, the Tribunal held that an agreement should not be reduced to a single “formal” written contract. On the contrary, previous invoices, cheques and written contracts may be sufficient to “control the conduct of the parties.” 6. Retroactive payments or adjustments. In the case of independent contract agreements and leases, Stark and AKS plans generally require that compensation or the rental rate be set in advance. (42 CFR 411.357 (a) (b), (d) and (l) and (1001.952 (b) (d)). Retroactive adjustments or payments that were not included in the original agreement are made outside the safe harbor. On the other hand, compensation in employment contracts should not be fixed in advance. CMS also reiterates the clarifications made in the preamble to the proposed rule regarding the CMS statements of the 2009 GJ IPPS rule on the parties` ability to remedy non-compliance retroactively. CMS recognizes and wishes to promote the fact that it is customary to actively monitor and correct administrative and operational errors or imbalances during “living financial relationships”.
However, once a financial relationship is over, CMS finds that the parties have lost the ability to correct or “cure” non-compliance retroactively. When a company attempts to use one of the exceptions to the strong law that require written documents, the parties must also sign the documents. This applies not only to the exception agreements covered in the provisions of P. 411.357, but also to the general exceptions listed in the provisions of S. 411.355 and to the exemptions of ownership and interest in investment mentioned in the provisions of P. 411.356. If an entity does not meet the signature requirement but meets all other criteria of the applicable exemption, CMS allows an entity to obtain the necessary signatures within 90 days of the non-compliance date, without losing the dhS refund entitled to which it is referred during that additional period.