Chapter 1: Introduction
Chapter 2: Related Tax and Non-Tax Topics
Chapter 3: Exemption Standards
General Qualification Under Section 501(c)(3)
Private Inurement and Private Benefit Tests
Lessons Learned from GCM
Excess Benefit Transactions: Taxpayer Bill of Rights 2 (TBOR2)
Effect of Private Benefit and Excess Benefit on Exemption
Captive and Friendly PCs
Chapter 4: Physician Compensation Packages for Tax-exempt Healthcare Organizations
Reasonable Compensation
Basic Standards for Incentive Compensation
HMO Compensation Plans
Other Safeguards and Faculty Practice Plans
Net, Gross, or Adjusted Gross Revenues
Caps on Total Compensation/Incentives
Impact of GCM 39862
Impact of IDS exemption Standards on Compensation Packages
Historical Compensation and Consultant's Opinions
Chapter 5: Impact of the Stark Law and Anti-Kickback Statute on Compensation
Anti-Kickback Statute
Stark Law
Advisory Opinions
Final rule regarding revised OIG Sanction authorities
Chapter 6: Worker Classification of Physicians
Definition of Employee for Federal Tax Purposes
IRS Enforcement Activities Relating to Worker Classification
Consequences of Worker Misclassification
Healthcare Industry Guidance
Sole Shareholder
Group Practice
Section 530 Relief
Summary and Strategies
Chapter 7: Academic Medical Centers
Overview of Practical Differences in AMCs
Stark law exceptions for AMCs
Anti-Kickback Statute Considerations
Tax Considerations
Workpapers and Practice tools
Chapter 8: Private Use of Bond-Financed Facilities
Qualified Use
Permitted Private Use
Revenue Procedure 97-13: Service Contracts
Revenue Procedure 2007-47: Basic Research
Revenue Procedure 97-15: Change in Use
Chapter 9: Gainsharing Programs
Basic Gainsharing Program Design
Cardiac Demonstration Project
Gainsharing for tax-exempt hospitals
Stark Law Issues
Anti-Kickback Statute
Obra 1986: the CMP Law and Physician Incentive Plans
Special Advisory Bulletin
Favorable OIG Gainsharing Advisory Opinions
Pay for Performance Initiatives
Current Status of Gainsharing Arrangements
Chapter 10: Virtual Equity Models
Overview of Virtual Equity Models
Objectives and Structure of Participating Bond Transactions
Tax Considerations
Stark Law Implications
Anti-Kickback Statute Considerations
CMP Law Considerations
Legal Opinions
Securities Law Issues
State Usury and Bucket Shop Laws
Other State Law Considerations
Practical Issues
Chapter 11: Other Physician Recruitment and Retention Incentives
General Recruitment Incentives
Anti-Kickback Statute Considerations
Stark Law Exceptions
Changing Market
Recruiting Costs
Signing Bonuses
Income Guarantees
Loans and Guarantee of Commercial Loans
Technology Assistance
Courtesy Discounts
Practice Management Services
Hospitalists and Midlevel Provider Services
Malpractice Insurance
Economic Credentialing
Life Insurance Premiums
Interview Expenses
Moving Expenses
Scholarships
Cell Phones
Leases and Rent Subsidies
IRS Physician Recruitment Ruling
Comparison with Hermann Hospital Guidelines
Payment of Attorney Fees
Chapter 12: Lawyer & Compliance Officer Liability
Fighting Fraud
The Anderson Case
Special Exposure of Compliance Officers
Routine Waiver of Privilege
Disclosure of Client Confidences
Best Practices for Attorneys
Defensive Drafting and Monitoring
Impact on Legal Opinions
Chapter 13: Preparing for Audit and Investigation
Reasons for Internal Investigations
Priori