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Anti-Kickback Safe Harbor

Payment of obstetrical malpractice insurance premiums for practitioners engaging in obstetrical practice by hospitals (and other entities) in primary care HPSAs, provided the following conditions are met:

  1. payment is in accordance with a written agreement between the hospital and practitioner;

  2. at least 75% of the subsidized practitioner’s patients are medically underserved patients;

  3. there is no requirement that the practitioner make referrals to hospital as condition for receiving the benefits;

  4. practitioner is not restricted from establishing staff privileges at any other entity;

  5. the amount of the payment does not vary based on the volume or value of referrals;

  6. the practitioner treats patients who receive benefits under federal health programs in nondiscriminatory manner; and

  7. the insurance is a bona fide malpractice insurance policy or program and the premium, if any, is calculated based on a bona fide assessment of the liability risk covered under the insurance.

13. Obstetrical Malpractice Insurance Subsidies

Sources: 42 C.F.R. § 1001.952(o)

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