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2019-10-30 FMV in Physician Employment and Professional Services Arrangements

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As the regulatory landscape in healthcare continues to evolve and healthcare providers are more frequently paying large settlements to the Department of Justice due to violations of the Stark Law and Anti-Kickback Statute, healthcare professionals need to ensure that they are best equipped to compensate ENT providers in ways that are both consistent with fair market value (FMV) and commercially reasonable.


This presentation covers the basics of FMV, why is matters and what key elements in an agreement could be considered problematic. It reviews a variety of topics, including background on the regulatory landscape, important items to consider in arrangements involving physician compensation models, and specific items to consider when reviewing ENT arrangements (e.g., review of survey data).  


Educational Objectives: 

  • Understand the ways in which employment and professional services arrangements relate to the Stark Law, Anti-Kickback Statute, and IRS private inurement prohibitions.
  • Learn the drivers of value and commercial reasonableness for both physicians and health systems.
  • Understand the key pitfalls in compensation plan design.
  • Detail specifics of FMV and commercial reasonableness in the context of ENT.


About The Speakers:

Nicholas J. Janiga, ASA, Partner

Nicholas Janiga is a Partner in HealthCare Appraisers’ Denver office, where he leads the firm’s business valuation and capital equipment valuation service lines.  He has been providing his clients analysis and consultation in business valuation, litigation support, intellectual property and healthcare provider compensation relationships since 2006.  His experience includes working with healthcare organizations, attorneys, administrators, providers, developers, consultants, investment bankers, and private equity groups in connection with a broad spectrum of transactions in the healthcare industry.  Many of the transactions he analyzes involve Stark, Anti-Kickback, IRC 501(c)(3), and other regulatory implications, which requires analysis of fair market value and the determination of commercial reasonableness.  He also has experience providing expert testimony in deposition and trial settings

Mr. Janiga is an Accredited Senior Appraiser (ASA) in Business Valuation through the American Society of Appraisers.  He holds a Bachelor of Business Administration from the Seidman College of Business at Grand Valley State University.  In 2018 he was recognized by the American Society of Appraisers as a “Rising Star” in the industry, and by Becker’s Healthcare as one of the healthcare industry’s “90 Healthcare Leaders Under 40”.


Kevin Cassell, Senior Associate

Kevin Cassell is a Senior Associate in HealthCare Appraisers Colorado office managing in a wide variety of projects, including the analysis of healthcare provider compensation valuation and business valuation. His focus includes compensation valuation arrangements, telemedicine services arrangements, and compensated call coverage.  Mr. Cassell holds a BBA in Corporate Finance and a BA in German from Colorado State University. 



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