What does New York Law Say About Medical Fee-splitting?
In general, New York law prohibits fee-splitting in the practice of medicine. This prohibition applies to both corporate and individual settings. In particular, New York Public Health Law § 4501 (1) expressly prohibits both firms and individual practitioners of medicine for profit in a way that "the practice of referral or recommendation of persons to a doctorDentist, hospital, health facility or pharmacy for any form of medical or dental care or treatment of a disease or physical condition. "The law also prohibits physicians and other health care professionals and facilities for medical or dental care and treatment to accept any person designated or recommended for such care or treatment by a medical or dental referral service business in or doing business in another state is if the medical or dental referral service business would be banned ... if the business were in or doing business in New York. "In simple terms, it is forbidden to give or accept fees for the patient recommendations.
Does the law does not distinguish between individual and corporate practice of medicine when it comes to sharing fees?
In New York by the companies and nonprofit organizations are not authorized to practice medicine per se, if they are certified to do so by the Public Health Council. Therefore, each> New York doctor who shares or other permits, such shares in the fees for medical services with a business entity will be disciplined under NY Education Law Section 6530 (19). Illegal fee-sharing with social forms can take many forms. For example, in one recent case, the court found that the payment of part of the income of doctors in their private practice clinic at a university as a condition for employment of physicians with the University of an illegal fee-splitting wasArrangement where the doctors were not employees of the university faculty practice Corporation and the University not to provide doctors with salary, benefits, equipment, supplies, personnel, insurance or malpractice. (V Odrich Terr. Columbia Univ.) Illegal fee-splitting is not always about money payments. Giving or receiving of a valuable benefit, such as credit, omission, discounts, tips, etc., can qualify as an interchange fee.
So, what is the commercial practice ofMedicine or illegal fee-splitting?
As an example, several court cases show the corporate practice of medicine and illegal fee-splitting. In one case, a doctor would be in an agreement with its engineers that if the EEG technician and ECHO tests and the doctor would do, they pay 50 percent of the fees used for the tests. In another case, a company employed doctors and provided them with office space and equipment in exchange for a certain percentage of their income.Another example is from a doctor who was his license for the payment of referral fees for the health of women, a center that he, based on patients exposed to have abortions.
Are there any exceptions?
Yes. The law allows physicians, medical fees and equity partnerships in practice, professional firms, university faculty practice plans, hospitals, HMOs and staff / student health programs. While such arrangements are permitted subject to restrictions. For example, aPhysician who is not a member of a partnership may not shares fees with the partnership.
What about the payment of salaries for employees?
Payment of salaries to employees is not illegal unless the salaries are exchange for a fee on the income of the doctor's quota and a certain percentage of their income. Fee-sharing with another physician is acceptable under certain circumstances, sub-contractors as was the case with a consultant or professional.
Is it a problem for a physician to employBilling company or a collection agency?
It depends on the nature of the agreement between the physician and the billing company. May default, many companies prefer a contingency plan based billing model, where the doctor a percentage of income of the doctor for free. While acceptable that the billing company, this practice is a safe way to professional discipline for the physician. The correct way would be represented for a fixed market value of the services agreed upon. But thisis different with the collections agencies. Collection agencies are paying on a contingency basis, depending on the amount recovered is not illegal fee-splitting.
What are the legal consequences of violating the fee-splitting laws and corporate practice of medicine?
In the latter case, because the companies are not allowed to practice medicine is the practice as "unlicensed practice of medicine", which is a Class E crime. If they are convicted, the defendant may serve between one to fourYears in prison and fines incurred. The company itself will be dissolved. Connect physicians that contracts with unlicensed commercial enterprises with fraudulent practice of medicine can be made through authorized accounts or the practice range and be subject to professional discipline. Illegal fee-splitting is a professional misconduct and any physician found to have violated the rules, the fee shall be disciplined.
