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Rule Proposal Published for "Sunshine" Provisions of Health Reform

Posted 4:18 PM by

Much of the health reform legislation had staggered starts, including the so called "sunshine" provisions around disclosure of financial relationships. There are a number of interesting implications under the proposed rules around Stark and fair market value compliance.

A quick summary is that companies providing remuneration to physicians beyond very minor incidental benefits will have to make a public disclosure of the activity. Even for unintentional non-disclosure, fines range from $1,000 to $10,000 per incident and go up by a factor of ten for intentional non-disclosure.

A full write up can be found here.

You can expect hopeful qui tam relators, attorneys general and other enforcement agencies to be mining the data to see where compensation is out of line with the related activity. For instance, compensation of $3,000 for attending a local, half-day weekend seminar may actually be an activity designed to induce a referral and therefore a disguised kickback. Companies out there providing legitimate education might want to invest in a fair market value opinion or some other valuation to ensure compliance if scrutiny is applied to their business activities.

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Katz, Sapper & Miller’s Healthcare Resources Group serves healthcare providers, including physicians, hospitals and health systems, surgery centers, and long-term care facilities. Our team of healthcare professionals has the scope and depth to meet client needs. Learn more.

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