In 2013, Intermountain Health reached a $25,500,000 agreement for allegations of numerous violations of anti-kickback status and the Stark Act involving eighteen (18) leases with physicians, which it had no memory of in the written agreements signed. Next, consider the furniture and appliances made available to the tenant on timeshare and used. The definition of the corresponding annual costs for furniture and equipment for furniture and equipment must include both exclusively used and common surfaces. These assets may terminate new or used furniture and equipment and may extend to the materiality of A-Z. This is important for an agreement in accordance with strong law, so it is easy to overlook the importance of this factor, it is important to work with a qualified party to determine the annual cost of the FMV of these assets. The most important of these considerations is the amount of rent. Rent must be „fair value, predetermined and disable, directly or indirectly, the volume or value of recommendations or other transactions generated between the parties.” If the tenant pays above fair value for the rented area, the OIG assumes that the tenant pays the landlord for the transfer of patients. If the tenant pays for the rental area below fair value, the OIG assumes that the tenant transfers the patients to the landlord for a reduced rent. The benefits of these agreements are enormous, but setting a reasonable-time rental rate for medical office futures is a difficult and complex process. Over the years, the Centers for Medicare and Medicaid Services (CMS) have become increasingly skeptical of the concept and have implemented strict rules. As stated in the Special Fraud Alert, „OIG is concerned that in such agreements [between physician-donors and other health care providers]” rents could be camouflaged to obtain referrals to physician owners. Lease agreements are generally considered to be suspect because of 1) the adequacy of the lease (i.e.
whether rent should be calculated for the space available); 2) the amount of rent; 3) time and space considerations (i.e. how much space is rented and how the rent is calculated based on how often the space is used by the tenant); or a combination of all three. Under The Stark Act, these fair value agreements (VMFs) must be entered into to ensure that a health care provider capable of returning patients to the medical facility does not receive undue benefits. Whether the medical institution provides or receives the services of the potential transfer source, there are many areas to consider to ensure that the agreement is compliant and to FMV. Tip: It`s not just square footage! Call it a hangover for a long time in manufacturing. Many medical practices, which have used the possibility of being rented by hospitals in a wave of transactions around 2008, are now bemoaning the terms of these agreements, which are coming.