A recent False Claims Act (FCA) ruling out of Tennessee offers a pointed reminder for hospitals and health systems: physician contracts that appear compliant on paper can still create serious enforcement risk if the economics tell a different story. In denying motions to dismiss FCA claims involving Erlanger Health System (Erlanger), the federal court allowed allegations regarding physician compensation to proceed, reinforcing that these arrangements remain fertile ground for qui tam relators and the Department of Justice (DOJ). For organizations contracting with physicians, the message is clear: independent fair market value (FMV) review, rigorous documentation, regular auditing, and meaningful board oversight are essential defenses, not mere optional safeguards.