HHS' inspector general's office issued a rare alert that warns physicians who charge Medicare beneficiaries extra money for special services to make sure Medicare-covered benefits aren't on the list or risk substantial penalties, including possible exclusion from federal healthcare programs. "We are hearing reports about physicians asking patients to pay additional fees, and we believe this is an ideal time to remind physicians and Medicare patients about this potential liability," HHS Acting Principal Deputy Inspector General Dara Corrigan said in the two-page alert. In a still-rare practice dubbed "boutique" or "concierge" medicine, physicians charge patients a membership fee in return for special benefits such as house calls and extended visits. The alert -- the first time the inspector general's office has addressed the issue of charging patients extra for special services -- is narrowly focused on Medicare beneficiaries and does not use the terms "boutique" or "concierge."
The alert cited a recent settlement with a Minneapolis internist who asked patients to sign a yearly contract and pay an annual fee of $600 for services not covered by Medicare, such as "coordination of care with other providers" and extra time spent on patient care. The inspector general's office alleged that many of the services were in fact covered by Medicare. The internist agreed to pay $53,400 in civil monetary penalties and to stop offering the contracts to resolve his liability. While it appears legal to charge Medicare beneficiaries extra for noncovered services, "in actual practice it may not be so easy to come up with a list of things to charge extra for," said Mac Thornton, an attorney with the Washington firm of Sonnenschein, Nath & Rosenthal and former chief counsel to the inspector general. Read the alert. -- by Mark Taylor