How illegal fee-splitting can cost you from New York Medical License What New York law say about splitting medical expenses?
In general, New York law prohibits fee-splitting practice of medicine. This prohibition applies to both individual and corporate settings. More specifically, New York Public Health Law section 4501 (a) expressly prohibits the companies and individuals to practice medicine practitioners for profit in a manner that includes "the referral or recommendation of persons to a physician , dentist, hospital, health facility or related to a dispensary for any form of medical or dental care or treatment of any disease or physical condition. "The law also prohibits physicians and other health professionals and facilities "to accept for medical or dental care or treatment of any person referred or recommended for such care or treatment by a firm of consulting medical or dental located in or doing business in another state if the medical or dental referral service business would be prohibited ... if the company is located in or doing business in New York. "In simple terms, it is forbidden to give or accept fees for referring patients .
The law makes no distinction between business and individual practice of medicine when it comes to cost sharing?
In New York, businesses and nonprofit organizations are not allowed to practice medicine in itself unless they are certified by the Public Health Council. Therefore, every doctor in New York that allows other shares or share expenses for medical services with a commercial entity will be punished under Article NY Education Law 6530 (19). commercial entities for the return of illegal commissions involving may take several forms. For example, in one recent case, the Court held that payment of part of the income of doctors in their private practice clinic at the university as a condition of employment with the University of doctors was a sharing arrangement with illegal payments, where doctors were not employees of the company practice, university faculty and the university did not provide physicians with salary, benefits, facilities, supplies, personnel, or insurance for misconduct. (Trs v Odrich. In Columbia Univ.) Cost sharing is illegal not always result in payments of money. Give or receive a valuable benefits such as credit, omission, discount, tips, etc. can be considered cost sharing.
So what is the practice of medicine, business or illegal fee-splitting?
For example, several court cases demonstrate the practice of medicine, business and illegal fee-splitting. In one case, a doctor concluded an agreement with its engineers that provided the technicians would perform EEG and ECHO tests and the doctor should not pay 50 per cent of the costs for testing. In another case a corporation employed physicians and provided facilities and equipment in exchange for a percentage of their income. Another example is a physician who had his license suspended for paying referral fees to a health center women who referred patients to him for abortions.
Are there any exceptions?
Yes. The law allows doctors to practice medicine and share the fees through partnerships, professional corporations, plans for teachers of the University practice, hospitals, HMOs, and the employee / student health programs. If approved, such arrangements are subject to restrictions. For example, a physician who is not a member of a society may not share fees with the partnership.
What about the payment of wages to employees?
Paying wages to employees is not illegal fee-sharing unless wages are income of the physician and a percentage of income. sharing fees with another physician is allowed under certain circumstances, as in the case of a professional consultant or managed.
Posted on February 1, 2010.