Are Groupons illegal in health care? – The Advisory Board Daily Briefing

Everyone is trying to save money these days, and using coupons is becoming more and more common.  Coupons can be found from dinners out to oil changes to… medical care?  Some websites, such as Groupon, take a portion of the payment received for the medical service.  This can be described as a form of fee-splitting or kick-back, which is illegal in medicine  in the US.  Other websites, such as MediBid, do not take a cut of what the physician receives from the patient.  They ask for merely a user fee to be listed on the site, as with using a Yellow Pages directory.  MediBid also does not ask physicians to give discounts or lower their usual rates, as these other coupon websites do.  MediBid relies instead on competition, to create market based pricing. Using coupons is a smart idea for material goods, but be wary of medical “deals” from sources which are skimming out of your physician’s pocket. Doctors need to be wary to avoid violating these laws.!

Are Groupons illegal in health care? – The Advisory Board Daily Briefing.

Are Groupons illegal in health care?

Health law experts question whether deals violate anti-kickback law

September 29, 2011

More providers are using websites like Groupon and Living Social to offer discounted care, but these new deals may run afoul of anti-kickback rules, medical law experts warn.

In an effort to grow their customer base, some physicians, dentists, and other health providers are offering deals through popular discount websites, where millions of shoppers take advantage of discounts of up to 90% on a variety of products, the South Florida Sun-Sentinel reports. Health providers typically offer discounts on elective services that are not covered by insurance.

For example, the Florida Center for Cosmetic Surgery in Fort Lauderdale has featured a $999 deal for laser liposuction surgery, which ordinarily costs $3,500, while East Boca Dental has featured deals like a $129 dental package that ordinarily costs $595 and includes an exam, X-rays, a cleaning, and whitening.

However, because the discount websites often keep as much as 50% of the payment, health lawyers say the practice may violate federal and state laws that prohibit kickbacks and splitting fees. Michael Segal, a health care attorney in South Florida, urges physicians to use caution when considering deals, noting that “[y]ou don’t want to find out there’s a concern after you have done it.”

To date, no state has disciplined a provider for offering an online discount. Most medical boards and associations, including the American Medical Association, have yet to take a position on the legality of the medical service discounts.

However, Amy Wandel, who has investigated online discounts for the American Society of Plastic Surgeons, predicts that some state boards eventually will make a decision on the issue. In Oregon, two medical boards already have banned dentist and chiropractors from offering Groupon-style discounts where the site receives part of the fees. In response, Oregon regulators claim that discount website Living Social changed its billing practice for medical business so that providers pay only an upfront fee, as they would with regular advertising.

Online discounts also may create concerns for patients. Specifically, Wandel notes that some patients have had trouble obtaining refunds for services they were unable to receive because of health issues or complications. In addition, one medical spa owner in Cooper City, Fla., says the discounts may encourage patients to choose price over quality (LaMendola, Sun Sentinel, 9/25).

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