13. Obstetrical Malpractice Insurance Subsidies
Same seven standards as Anti-Kickback:
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payment is in accordance with a written agreement between the hospital and practitioner;
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at least 75% of the subsidized practitioner’s patients are medically underserved patients;
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there is no requirement that the practitioner make referrals to hospital as condition for receiving the benefits;
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practitioner is not restricted from establishing staff privileges at any other entity;
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the amount of the payment does not vary based on the volume or value of referrals;
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the practitioner treats patients who receive benefits under federal health programs in nondiscriminatory manner; and
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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.
Stark General Exception
Sources: 42 C.F.R. § 411.357(r)