Practices Share Lessons of Benefitting from Concierge Care while Accepting Medicare

August 26, 2013 – In The News
Part B News

William Maruca was quoted in the Part B News article "Practices Share Lessons of Benefitting from Concierge Care while Accepting Medicare." While the full text can be found in the August 26, 2013, issue of Part B News, a synopsis is noted below.

Physician-owners who are tired of hassles associated with Medicare frequently tell Part B News that they’d like to move to a different model. One way to do so is to switch to a “concierge” or cash-only practice. A full transition to concierge care is a big step which is why some practices use a hybrid model in which Medicare providers serve patients who pay a fee for personalized services and those who don’t. The arrangement for service of a mixed patient population is important – especially legally.

You can’t lower the quality of covered services for patients who don’t pay a subscription fee. “The law prohibits doctors from charging individuals in Medicare for services they’re already entitled to,” says William Maruca. Also, the law defines “coercive activity” as anything that puts “pressure on the patients to pay subscription fees or risk having to switch physicians,” which is illegal, explains Maruca.

When considering switching to this type of practice, there are a few things to keep in mind. MDVIP, a large concierge medicine company, will help navigate the legal issues but it is important to remember that “their lawyers work for them, not you,” says Maruca. You should also prepare your patients and staff by educating them.

One thing you definitely have to get patients to do is commit to not sending claim forms on your noncovered services to Medicare, says Maruca: “Lock it down with your patient agreement.”