The Stark statute has become the basis for some astoundingly high verdicts and settlements in the last few years. While one might think that in the developing value driven health care environment the risk of over-utilization because of financial relationships would become a diminished concern, in August 2014 the government entered into the first Stark settlement ever with respect to improper compensation within a private physician practice!  Still further, the bad compensation occurred in 2007 and 2008.  The group apparently compensated its partners based on the volume of nuclear scans and CT scans they ordered.  The group agreed to pay more than $1.33 million dollars to the government. We have been focused on issues associated with physician compensation for years, but before even knowing about the pending settlement we developed a teleconference which illuminates proper compensation practices including profit sharing, productivity bonuses, incident to and anti-markup principles.  This is now a must listen to MP3 since it is clear that the government will use its enforcement authority to reach deep within private practices. The settlement motivated Alice to dig deeply into the confounding intersections of Stark and Medicare reimbursement, in “Stark and Medicare’s Physician Reimbursement Rules: Unraveling the Knots.” It is time to review what you are doing.