A key requirement of many Stark Law exceptions is that when a DHS entity has a compensation arrangement with a physician, the compensation may not be “determined in any manner that takes into account the volume or value of the referrals or other business generated between the parties.” Over the years, CMS has struggled to provide a clear explanation of what this phrase actually means, often tackling the topic indirectly, through various “special rules” and exceptions. This morass, in turn, has contributed to several problematic court rulings. Despite CMS seeking to clarify its position on this issue in the 2020 rulemaking, the results are a mixed bag. This webinar explores this complicated area in detail, touches upon the new definition of the “volume or value” standard, the impact of self-performed services, the role of flat fee payments, and the sun-setting of the unit-based special rules on compensation. 

Presentation materials

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White paper

In December 2020, the Centers for Medicare & Medicaid Services (CMS) finalized its long-awaited changes to the agency’s regulations governing the federal physician self-referral law, commonly known as the Stark Law (Final Rule). The Final Rule represents the most significant Stark Law rulemaking in more than a decade. The Health Care Group at Dentons US presented a series of seven webinars, each with a companion white paper, addressing the principal components of the Final Rule. This is the third of these white papers, covering what is arguably the Stark Law’s key substantive requirement, the so-called “volume or value” standard (Volume/Value Standard).

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