Facts about Fee Splitting in a Joint Healthcare Practice


Healthcare law has undergone a massive overhaul in recent years. Keeping up with the changes presents real challenges to physician’s offices, health care practitioners and others involved in practice management. It’s important to consult with a qualified Boca Raton Healthcare law firm to keep abreast of changes in the law and state and regulatory compliance. One frequent source of confusion and/or potential problems come in the case of fee splitting between physicians and other healthcare professionals.

The Potential Problem with Fee Splitting

As your Boca Raton Healthcare lawyer can explain, when you accept Medicare or Medicaid funds for payment of healthcare services, this puts your practice under the supervision and scrutiny of the Department of Health and Human Services. Legislation relating to the healthcare industry strictly prohibits kickbacks of goods or services in exchange for referrals. In some cases, if a physician refers a patient out for testing and then splits the fee with the laboratory, this can trigger a violation of the anti-kickback legislation. The Office of the Inspector General has put out special fraud alerts that target exactly that kind of situation. Even innocent or benign fee splitting can be the cause for concern.

Regulatory Compliance in the Case of Fee Splitting

Your Boca Raton Healthcare lawyer can discuss a variety of ways to help avoid triggering a fraud alert in the case where referrals are made to laboratories. A healthcare practice can be administratively structured as a “medical mall” where a patient can receive a variety of services under one roof. Your attorney can discuss the advantages and disadvantages and how to structure payments in compliance with state and federal law. Another model may be to structure the business to offer integrated care where the physician’s office may contract for administrative service. Again, your attorney can review your current business plan, how you receive payments and provide strategies to help ensure regulatory compliance.

Consultation with a Boca Raton Healthcare Lawyer Webb Millsaps is a premier Boca Raton Healthcare law firm who can help you understand the complex healthcare laws that relate to practice management. To schedule an appointment for an initial consultation call (561) 900-7238.

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