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    Comparison Chart of Stark Exceptions and Anti-Kickback Safe Harbors

    These charts have been updated to reflect the changes to the Stark Law or Anti-Kickback Statute that were made final in November 2020, and became effective January 19, 2021. You also can review all the changes in this publication.

    Note that while we have made every effort to keep these charts accurate and timely, you should never rely on them entirely without also checking the actual regulatory language.


    Academic Medical Centers

    Ambulance Replenishing

    Ambulatory Surgery Centers

    Assistance to Compensate a Nonphysician Practitioner

    Certain Arrangements With Hospitals

    Charitable Donations by a Physician

    CMS Sponsored Model Arrangements and Patient Incentives

    Community-Wide Health Information Systems

    Cooperative Hospital Service Organizations

    Compliance Training

    Cybersecurity

    Discounts

    Electronic Health Records Items and Services

    Electronic Prescribing Items and Services

    Employment Relationships

    EPO and Other Dialysis-Related Drugs

    Eyeglasses and Contact Lens Following Cataract Surgery

    Fair Market Value Compensation

    Federally Qualified Health Centers

    Group Practice Arrangements With a Hospital

    Group Purchasing Organizations

    Implants in an ASC

    Increased Coverage, Reduced Cost-Sharing Amounts, or Reduced Premium Amounts Offered by Health Plans

    Indirect Compensation Arrangements

    In-Office Ancillary Services

    Intra-Family Rural Referrals

    Investment Interests

    Publicly-Traded Securities/Large Investment Interests
    Mutual Funds
    Investment Interests Held by Either Active or Passive Investors
    Investment Interests/Joint Ventures in Rural or Underserved Areas
    Investments in Group Practices
    Hospital Investment or Ownership

    Isolated Transactions

    Limited Remuneration to a Physician

    Local Transportation

    Medical Staff Incidental Benefits

    Non-Monetary Compensation

    Obstetrical Malpractice Insurance Subsidies

    Patient Engagement and Support and CMS Sponsored Models 

    Payments by a Physician

    Personal Service Arrangements

    Physician Services

    Physician/Practitioner Recruitment

    Preventive Screening Tests, Immunizations, and Vaccines

    Price Reductions Offered by Contractors With Substantial Financial Risk to Managed Care Organizations

    Price Reductions Offered to Eligible Managed Care Organizations

    Price Reductions Offered to Health Plans

    Professional Courtesy

    Referral Agreements for Specialty Services

    Referral Services

    Rental of Office Space and Equipment

    Retention Payments in Underserved Areas

    Risk Sharing Agreements

    Sale of Practice

    Services Furnished by an Organization to Enrollees

    Timeshare Arrangements

    Value-Based Arrangements

    Value-Based Arrangements with Meaningful/Substantial Downside Risk

    Value-Based Arrangements with Full Financial Risk 

    Waiver of Coinsurance and Deductibles

    Warranties