In my experience, many healthcare providers fail to take seriously the importance of fair market value in their business arrangements.  In fact, one of the most important means of ensuring compliance with federal and state fraud and abuse laws such as the federal anti-kickback and Stark is to ensure that financial arrangements – particularly where there are referrals relationships -are consistent with fair market value.  As an example of the consequences of failing to pay adequate attention to the issue of fair market value, consider this recent Department of Justice Settlement as reported by  Fair market value really does matter.