By Michael J. Sacopulos, JD
From dancing lessons to dinner cruises, group discount sites like Groupon and Living Social have lots to offer at low or lower-than-usual costs. Many aesthetic practices would like to throw their hat into this ring, but there may be a catch.
Advertising on such group discount sites may constitute fee splitting, and the American Medical Association states in no uncertain terms that fee splitting or payment by or to a physician solely for the referral of a patient is unethical.
So is it or isn’t it flirting with fee splitting to offer deals on these sites?
“A physician engaged in any sort of relationship, whether it be with an advertising company or some other entity, if they are giving a percentage of the fees they are receiving from medical services over, that is always going to draw board scrutiny,” says North Carolina Medical Board Attorney Todd Brosius, JD.
The North Carolina Medical Board received several complaints about doctors who were using these sites to grow their practices and recruit new patients. The board initially wanted to know if the advertising constituted fee splitting, and found that it did not but that some guidance was needed to make sure it stayed that way.
“Because there are varying models with regard to voucher advertising, we felt like it was a good idea to put out a policy statement that would provide a safe harbor as to how people could use voucher advertising without going astray and getting into the fee splitting arena,” Brosius says. Washington State, too, has such a statement in place.
According to the North Carolina Medical Board, advertising involving the utilization of vouchers does not constitute unethical fee splitting or a prohibited solicitation of a referral fee as long as the negotiated fee between the voucher advertising company and the licensee represents reasonable compensation for the cost of advertising, and that appropriate terms and conditions are highlighted in a clear and conspicuous manner in all ads. These include a description of the discounted price in comparison to the actual cost, a disclosure that all patients may not be appropriate candidates, and that, in the event that they are not, they will be given a full refund. If the voucher advertising company does not refund the patient, the physician or practice must do so in full.
“When physicians enter into this kind of relationship, they should do their homework. It can be done correctly as it can hopefully help their practices be able to draw patients in a way that does not run afoul of the law or the medical board,” Brosius says.
Many state medical boards have not issued guidelines or policy statements on the fee splitting issue yet. Physicians using these sites without the approval of their state’s medical board should ask if the site get a set fee or a percentage of each patient’s payment, and provides a full refund. Be smart, and make a quick call to your state medical board before using Groupon/Living Social as a vehicle for advertising.
ASAPS Weighs in on Beauty Bargains, Too
The American Society for Aesthetic Plastic Surgery (ASAPS) is also helping shape the debate on the group deal by appealing directly to patients. “Patients must do their homework when choosing where and with whom to have any medical procedure,” says ASAPS President Jack Fisher, MD, in a news release. “Cost is always a factor, but it should never be the deciding factor in cosmetic surgery. Safety and quality are always the key issues.”
ASAPS is urging patients to ask certain questions before they click “Buy,” even if the deal seems like a total steal. Patients should ask if the Medi-spa is located within a physician’s office. If the answer is no, they should request the name of the physician responsible for oversight and find out when they are available for consultation or questions before having the procedure, regardless of the cost. Patients should also always ask about credentials of the physician supervising the treatment, and whether or not the product has been approved by the federal Food and Drug Administration.
What’s the verdict on group discounts? Better safe than sorry, and that stands for the patient as well as the physician.
| Michael J. Sacopulos, JD, is the CEO of Medical Risk Institute (MRI) and serves as general counsel for Medical Justice Services. Additionally, he is the legal analyst for several national publications, including Plastic Surgery Practice. He may be reached via [email protected]. |
Michael J. Sacopulos, JD, is the CEO of Medical Risk Institute (MRI) and serves as general counsel for Medical Justice Services. Additionally, he is the legal analyst for
several national publications, including Plastic Surgery Practice. He may be reached via [email protected].
