Anti-kickback status generally prohibits the offering, payment, payment, request, or obtaining compensation in order to obtain or reward recommendations for items or services to be paid for by public health programs, including Medicare and Medicaid.15 Federal anti-kickback law is violated when «one of the purposes» of the transaction is to establish or reward prohibited recommendations, Unless: The agreement is structured in such a way that it fits into a regulatory safe harbor.16 Although the anti-kickback safe harbor requirements vary in some details of the strong safe harbor17 Companies will likely meet the anti-kickback status if they structure their agreements in a way that matches Stark. Regardless of this, companies should carefully and regularly check their medical contracts to ensure compliance with current legislation. Hospitals and transfer service providers can set up joint ventures, for example. B co-ownership of an outpatient operation centre; service line; the organization of management services; holding company; etc. These agreements must be carefully structured to ensure compliance with the rules of force and the AKS. As a general rule, reference suppliers should pay a fair market value for their ownership shares, and the return on investment should reflect their investment and not be based on the volume or value of the recommendations. There are other safe harbor conditions. 6. Neither the eligibility of a physician for the goods or services nor the amount or type of goods or services shall be determined in a manner that directly takes into account the volume or value of transfers or other transactions generated between the parties. .