3 legal issues to consider with a concierge practice

Male doctor in white lab coat
Doctors need to address some legal questions when opening a concierge practice. Getty/Saklakova

For primary care physicians thinking of transitioning to a concierge or direct care model, there are some legal issues to consider.

Doctors opening a concierge practice may face a number of legal and compliance challenges, according to a post on the Connecticut Health Law Blog. First, a doctor who chooses to switch to a purely concierge practice should ensure a smooth transition for all patients, including those who choose not to move to the direct care practice so they don't think the physician is abandoning them.

Then consider these legal concerns:


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  • Medicare-covered services: If you don’t choose to opt out of Medicare, be careful about concierge services that could be considered Medicare-covered services, according to the post. The Office of Inspector General of the U.S. Department of Health has not issued any specific guidance on which services may be considered covered services, leaving practices with some uncertainty.
  • Written contracts: Practices should have a written contact with each concierge patient, according to the post. The contract should describe the fee the patient will pay and the services the practice will provide.
  • HIPAA issues: If you have a hybrid practice, where you combine traditional and fee-paying patients, and you use a separate company to provide concierge services, there may be a need for a business associate agreement with that company. Be sure you maintain privacy if you communicate with patients via texts or emails.

While concierge medicine has become an alternative to some physicians, the failure of two major businesses that pioneered direct primary care practice has left the future of the model in question. The closure of direct primary care businesses Qliance Medical Management and Turntable Health has raised some doubts within the industry about the sustainability of the model, as Fierce Healthcare reported.

RELATED: Future of direct primary care in question as two pioneering businesses close

But that's not the case for ultra-elite concierge practices that charge as much as $80,000 a year to provide care to America's wealthiest patients. Physicians interviewed by The New York Times said business is booming. In addition to 24-hour access, these physicians will make house calls or meet clients at work or an airport. They also will provide their patients with immediate access to the country’s finest specialists and hospitals, unlike most average Americans who have to wait as long as 29 days for an appointment.

RELATED: High-end, high-cost concierge medicine for America’s wealthiest widens healthcare divide

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