Photo Credit: iStock.com/AndreyPopov
You ask, she answers! Dr. MedLaw responds to a physician’s question regarding fee-splitting, leading to a discussion of kickbacks and regulatory claims.
Physican: I’m expanding my internal medicine practice to include more wellness care, and I want to market that. There is a local firm whose offices I often pass by, and the displays of their work in their window looked very good, so I contacted them. They stated that they had never worked for a medical practice before and were excited to get into the area. They said that they can either bill by the hour or take a percentage of the business they generate for me. They said that most of their clients do it the second way. Obviously, I prefer that option because I don’t have to pay upfront, and it gives them an incentive to deliver results. Is it OK to do this, or is it fee-splitting?
Dr. MedLaw: Since this is not a physician group being given part of a fee that you charged a patient that they referred, it would not be fee-splitting.
However, the definition of a kickback is wider and includes offering, paying, soliciting, or receiving anything of value to induce or reward referrals and once you start paying a portion of the revenue that you gained from new referrals as a result of the marketer’s work to the marketers it can be seen as payment for the generation of referrals. This is fine for their commercial clients, but not for you as a physician.
While it is frankly unlikely that this will ever be a regulatory claim against you it would not be a fight that you would want to have so go with the hourly rate and, of course, make sure to get itemized bills every month and keep tabs on where your money is going versus the benefits to the practice that the marketing firm is generating. Keeping a satisfied customer who can help them open into a new area should be enough of an incentive to get them to work hard for you.
Check out Dr. MedLaw‘s prior Q&A columns regarding how to decrease liability risk for on-call telephone consultations, and gaining patient consent during medical emergencies.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Physician’s Weekly, their employees, and affiliates.
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