Part 1: Artificial Intelligence (AI) & Fair Market Value (FMV) under Stark Law & Anti-Kickback Statute (AKS): A Discussion with Chris David, Managing Partner, HealthValue Group

Episode Date: February 24, 2026

In this episode of Stark Integrity, Bob Wade (Captain Integrity) is joined by Chris David, Managing Partner at HealthValue Group, to explore a rapidly evolving and highly technical area of healthcare compliance:

The intersection of artificial intelligence (AI) and fair market value (FMV) under the Stark Law and Anti-Kickback Statute (AKS).

This episode marks Part 1 of a two-part series, focusing on how AI is beginning to influence FMV analysis and physician compensation arrangements.

The core message:

AI can significantly improve efficiency—but it must be used carefully to ensure compliance and defensibility.

AI and the Evolution of FMV Analysis

A central theme of the episode is:

How AI is changing the way FMV analyses are performed.

Traditionally, FMV determinations involve:

• Market data and benchmark surveys
• Professional judgment and experience
• Detailed documentation and analysis

With AI, organizations can now:

• Process large volumes of data quickly
• Identify trends and outliers
• Generate preliminary valuation models

The takeaway:

AI has the potential to streamline FMV work—but it does not replace human expertise.

Efficiency vs. Defensibility

As discussed by Chris David, one of the biggest considerations is:

Balancing efficiency with defensibility.

AI can:

• Save time
• Reduce manual workload
• Improve consistency

However:

• Outputs may lack context
• Assumptions may not be transparent
• Results may not be fully supportable

The key point:

An efficient analysis is not necessarily a defensible one.

AI Use Cases in Healthcare Valuation

The episode highlights practical applications of AI in FMV and compliance, including:

• Reviewing compensation arrangements
• Analyzing benchmarking data
• Identifying anomalies in physician pay
• Supporting documentation development

The takeaway:

AI can support the process—but should not replace judgment.

Regulatory Considerations

A key question explored in the episode is:

How regulators view AI-generated analyses.

In the context of Stark Law and AKS:

• Documentation must be reliable and supportable
• Assumptions must be clear
• Analyses must withstand scrutiny

The key point:

Regulators expect defensible reasoning—not just generated outputs.

The Importance of Human Judgment

Throughout the discussion, Chris David emphasizes:

The continued importance of human judgment in FMV determinations.

AI tools may:

• Provide inputs
• Suggest conclusions
• Highlight trends

But they cannot:

• Fully understand context
• Exercise professional judgment
• Defend conclusions in a regulatory setting

The takeaway:

AI enhances expertise—but does not replace it.

Risks of Overreliance on AI

The episode cautions against:

Overreliance on AI-generated outputs.

Risks include:

• Blind acceptance of results
• Lack of transparency in methodology
• Inadequate documentation

The key point:

Using AI without validation creates compliance risk.

Documentation and Support

In FMV analyses, documentation remains critical.

Organizations must ensure:

• Clear explanation of methodology
• Support for assumptions
• Alignment with regulatory requirements

Even when AI is used:

The responsibility for documentation remains with the organization.

Practical Considerations

To use AI effectively in FMV and compliance, organizations should:

• Understand how AI tools function
• Validate outputs independently
• Maintain strong documentation standards
• Involve experienced professionals in the process

Because:

AI should support—not replace—a structured compliance approach.

Key Takeaways

• AI is influencing how FMV analyses are performed
• Efficiency gains must be balanced with defensibility
• AI can support valuation work but cannot replace professional judgment
• Regulatory expectations still require transparency and documentation
• Overreliance on AI introduces compliance risk
• Human expertise remains essential
• AI should be integrated carefully into compliance processes

Final Thoughts

This episode introduces an important and evolving question:

How should healthcare organizations incorporate AI into highly regulated areas like FMV analysis?

With insights from Chris David, the answer becomes clear:

• Use AI thoughtfully
• Maintain strong documentation
• Rely on professional judgment

Ultimately:

AI is a powerful tool—but it must be used within a disciplined compliance framework.

Because in healthcare compliance:

Speed and efficiency are valuable—but defensibility is essential.

Click here to listen to this Stark Integrity Podcast Episode:
https://podcasts.apple.com/us/podcast/part-1-artificial-intelligence-ai-fair-market-value/id1588939373?i=1000751320078&l=fr-FR