Page 289

107 STAT. 600 PUBLIC LAW 103-66—AUG. 10, 1993 "(A) IN GENERAL.—^Remuneration from an entity under an arrangement (including remuneration for specific physi- cians' services furnished to a nonprofit blood center) if— ''(i) the arrangement is set out in writing, signed by the parties, and specifies the services covered by tne arrangement, "(ii) the arrangement covers all of the services to be provided by the physician (or an immediiate family member of such physician) to the entity, "(iii) the aggregate services contracted for do not exceed those u^t are reasonable and necessary for the legitimate business purposes of the arrangement, "(iv) the term of the arrangement is for at least lyear, "(v) the compensation to be paid over the term of the arrangement is set in advance, does not exceed fair market value, and except in the case of a physician incentive plan described in subpara^aph (B), is not determined in a manner that takes into account the volume or value of any referrals or other business generated between the parties, "(vi) the services to be performed under the arrangement do not involve the coimseling or pro- motion or a business arrangement or other activity that violates any State or Federal law, and "(vii) the arrangement meets such other require- ments as the Secretary may impose by reflation as needed to protect against program or patient abuse. "(B) PHYSICIAN INCENTIVE PLAN EXCEPTION.— "(i) IN GENERAL.—^In the case of a physician incen- tive plan (as defined in clause (ii)) between a physician and an entity, the compensation may be determined in a mcuiner (through a withhold, capitetion, bonus, or otherwise) that takes into account directly or indirectly the volume or value of any referrals or other business generated between the parties, if the plan meets the following requirements: "(I) No specific payment is made directly or indirectly under the plan to a physician or a physi- cian group as an inducement to reduce or limit medi^ly necessary services provided with respect to a specific individual enrolled with the entity. "(II) In the case of a plan that places a physi- cian or a physician group at substontial financial risk as determined by the Secretary pursuant to section 1876(iX8XAXii), the plan complies with any requirements the Secretory may impose pursuant to such section. **(III) Upon request by the Secretory, the entity provides the Secretary with access to descriptive information regarding the plan, in order to permit the Secretary to determine whether the plan is in compliance with the requiremento of this clause, "(ii) PHYSICIAN INCENTIVE PLAN DEFINED.—^For pur- poses of this subparagraph, the term 'physician incen- tive plan' means any compensation arrangement between an entity and a physician or physician group