This article discusses the recent settlement of National Spine and Pain Center signed with the U.S. Department of Justice and provides the basis to discuss the importance of obtaining an opinion regarding the FMV physician compensation. On August 6, 2021, the U.S. Department of Justice announced that it had reached a settlement with National Spine and Pain Center, LLC (NSPC), a Maryland physician management services organization (MSO). As part of the settlement agreement, NSPC signed a non-prosecution agreement and agreed to pay $5.1 million to resolve criminal Medicare Anti-Kickback Statute violations.[1] An affiliate of NSPC, Physical Medicine Associates, Ltd. (PMA)…