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Title: Fair Market Valuation
Subject: Office of Compliance & Corporate Integrity (OCCI)
Policy No: OCCI: 2013: C06
Applies: RowanSOM
Issuing Authority: Rowan President & RowanSOM Dean
Responsible Authority: RowanSOM Chief Compliance and Privacy Officer
Adopted: 12/15/2009
Reviewed: 09/07/2011
Amended: 07/01/2013
Last Reviewed: 12/30/2014
I. PURPOSEPURPOSE
To provide guidance as to Rowan University School of Medicine's (RowanSOM) process of determining whether a transaction with a Potential Referral Source (as defined below) is made at fair market value in order to comply with Stark Law (42 U.S.C. § 1395nn ) and the Anti-kickback Statute (42 U.S.C. § 1320(a)-7b(b)).
II. ACCOUNTABILITY
Under the direction of the President, the Dean, General Counsel, and Chief Compliance and Privacy Officer are to ensure compliance with this policy. The deans and chief executive officers shall implement this policy.
III.
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APPLICABILITY
This policy applies to all RowanSOM operating units, including but not limited to hospitals, physician practices and outpatient centers.
IV. DEFINITIONSDEFINITIONS
A. "Referral Source" - an actual source of health care business or referrals to RowanSOM, or between RowanSOM and a physician (or a physician's immediate family member (as defined at 42 CFR. 411.351) - include, but are not limited to, another Physician, hospitals, long-term acute care centers, nursing homes, clinics, physician group practices, therapists and other individuals and entities who are in a position to influence or make referrals.
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E. "Potential Referral Sources" - physicians, hospitals, long-term acute care centers, nursing homes, clinics, physician group practices, therapists and other individuals and entities who are in a position to influence referrals.
V. REFERENCES
A. Professional Services Agreements
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G. Corporate Integrity Agreement Between the Office of Inspector General of the Department of Health and Human Services and the University of Medicine and Dentistry of New Jersey, September 25, 2009.
VI. POLICYPOLICY
A. Any transaction with an Actual or Potential Referral Source is to be at fair market value. Whenever RowanSOM requires a fair market valuation in order to comply with Federal or State laws and regulations or with its own policies and procedures, no conflict of interest, such as the ability of one party to refer patients or other business to the other, may affect the terms of the transaction or the valuation.
B. The Office of Compliance and Corporate Integrity will educate responsible parties on the laws, regulations and policies regarding the need for fair market value determinations, will monitor and review agreements, will review the fair market value documentation attached to agreements and attest to the appropriateness and reasonableness of the methodology used by the business units as reflected in the documentation provided by the business units for the services rendered under such agreement and will assist the responsible dean or vice president with remediating such agreements when potential violations of this policy are detected.
VII.
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ATTACHMENTS
A. Attachment 1, Procedure for Determining Fair Market Value
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