The Physician Arrangement Compliance Self-Audit

What’s in it

Seven yes/no tests, each with a clear pass and a clear fail, plus a fillable result block, an interpretation guide, and the enforcement history behind each test. Every test is scored against the standard an external reviewer would apply.

1. TEST 1Are FMV opinions current across all active arrangements?Fair market value currency — the most common Stark exception failure.
2. TEST 2Is every element of the applicable Stark exception documented?Strict liability: one missing element voids the whole exception.
3. TEST 3Is compensation independent of referral volume or value?The volume-or-value condition — where the largest matters are decided.
4. TEST 4Is Anti-Kickback intent analyzed, not just Stark exception fit?The test most programs fail — and the one the 2026 standard added.
5. TEST 5Is the documentation contemporaneous rather than reconstructed?Reconstruction is a red flag an adversarial insider can expose.
6. TEST 6Is exclusion screening current across every counterparty?Payments to an excluded party are non-payable, with CMP exposure.
7. TEST 7Is your audit trail tamper-evident?Records that can’t prove they weren’t altered prove less than they appear.

Who it’s for

• Compliance officers at hospitals, health systems, and integrated delivery networks.
• Healthcare counsel running external or pre-transaction compliance reviews.
• Anyone auditing a physician arrangement portfolio against Stark and the Anti-Kickback Statute.

The framework in context

The checklist condenses the reasoning behind each test into a printable, fillable format. For the full write-up — regulatory citations, the six personal-services elements, and the enforcement record — read the 7-test framework in full. For why fair market value alone no longer shields an arrangement, see the April 2026 OIG intent shift.

What to do with your results

Pass all seven and your program is operating at the post-April 2026 standard; the remaining risk is consistency across the whole portfolio. Fail one or two and targeted remediation is achievable — start with Test 4. Fail three or more and the honest read is that the program needs infrastructure, not remediation: spreadsheet-based tracking cannot pass Tests 4, 5, and 7 at any scale.