Page:United States Statutes at Large Volume 103 Part 3.djvu/172

 103 STAT. 2240 PUBLIC LAW 101-239—DEC. 19, 1989 " (3) CIVIL MONEY PENALTY AND EXCLUSION FOR IMPROPER CLAIMS. —Any person that presents or causes to be presented a bill or a claim for a service that such person knows or should know is for a service for which payment may not be made under paragraph (1) or for which a refund has not been made under paragraph (2) shall be subject to a civil money penalty of not more than $15,000 for each such service. The provisions of section 1128A (other than the first sentence of subsection (a) and other than subsection (b)) shall apply to a civil money penalty under the previous sentence in the same manner as such provi- sions apply to a penalty or proceeding under section 1128A(a). " (4) CIVIL MONEY PENALTY AND EXCLUSION FOR CIRCUMVENTION SCHEMES. —Any physician or other entity that enters into an arrangement or scheme (such as a cross-referral arrangement) which the physician or entity knows or should know has a principal purpose of assuring referrals by the physician to a particular entity which, if the physician directly made referrals to such entity, would be in violation of this section, shall be subject to a civil money penalty of not more than $100,000 for each such arrangement or scheme. The provisions of section 1128A (other than the first sentence of subsection (a) and other than subsection (b)) shall apply to a civil money penalty under the previous sentence in the same manner as such provisions apply to a penalty or proceeding under section 1128A(a). (5) FAILURE TO REPORT INFORMATION.—Any person who is required, but fails, to meet a reporting requirement of subsec- tion (f) is subject to a civil money penalty of not more than $10,000 for each day for which reporting is required to have been made. "(h) DEFINITIONS.— For purposes of this section: " (1) COMPENSATION ARRANGEMENT; REMUNERATION.— (A) The term 'compensation arrangement' means any arrangement involving any remuneration between a physician (or immediate family member) and an entity. "(B) The term 'remuneration' includes any remuneration, directly or indirectly, overtly or covertly, in cash or in kind. "(2) EMPLOYEE. —An individual is considered to be 'employed by' or an 'employee' of an entity if the individual would be considered to be an employee of the entity under the usual common law rules applicable in determining the employer- employee relationship (as applied for purposes of section 3121(d)(2) of the Internal Revenue Code of 1986). "(3) FAIR MARKET VALUE.— The term 'fair market value' means the value in arms length trsuisactions, consistent with the general market value, and, with respect to rentals or leases, the value of rental property for general commercial purposes (not taking into account its intended use) and, in the case of a lease of space, not adjusted to reflect the additional value the prospective lessee or lessor would attribute to the proximity or convenience to the lessor where the lessor is a potential source of patient referrsds to the lessee. (4) GROUP PRACTICE. —The term 'group practice' means a group of two or more physicians legally orgsuiized as a partner- ship, professional corporation, foundation, not-for-profit cor- poration, faculty practice plan, or similar association— "(A) in which each physician who is a member of the group provides substantially the full range of services

�