5. Employees

Stricter than Anti-Kickback:

Any amount paid by an employer to a physician (or immediate family member) who has a bona fide employment relationship with the employer for the provision of services if the following conditions are met:


1.  The employment is for identifiable services.

2.  The amount of the remuneration under the employment is:

(i) Consistent with the fair market value of the services; and

(ii) Except as provided in paragraph 4 below, is not determined in a manner that takes into account (directly or indirectly) the volume or value of any referrals by the referring physician.

3.  The remuneration is provided under an arrangement that would be commercially reasonable even if no referrals were made to the employer.

4.  Paragraph 2(ii) above does not prohibit payment of remuneration in the form of a productivity bonus based on services performed personally by the physician (or immediate family member of the physician).

Stark General Exception

Sources: 42 C.F.R. §  411.357(c).