Concierge Medicine

Concierge medicine goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. By any name, concierge medicine is the solution for doctors trying to maintain their integrity and independence in today’s difficult healthcare environment.Concierge medicine is a new style of practice with old roots, in which doctors limit their patient base in order to provide patients with personalized service, high quality care, 24-7 availability, and other amenities. In exchange for this enhanced personal attention, patients pay physicians an annual fee. This concierge fee enables physicians to increase their compensation while managing their workload. In addition to receiving an annual fee, most concierge physicians continue to receive reimbursements from health plans and private pay clients. Concierge medicine is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design.The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all concierge medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged. There are an estimated 5,000 concierge, or membership medicine doctors throughout the U.S. Concierge physicians care for fewer patients than in a conventional practice. All generally claim to be accessible via cell phone or email at any time of day or night or offer some other special service beyond the normal care provided. The annual fees vary widely, from $600 to $5,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services. Some concierge practices do not accept insurance of any kind. These are as cash-only or direct primary care practices. By refusing to deal with insurance companies, these practices can keep overhead and administrative costs low, thereby providing affordable healthcare to patients. They become concierge only if the practice assesses an annual or monthly fee instead of or in addition to a fee for each medical service. Other concierge practices do take insurance, even Medicare, but ask for an annual fee for additional services exclusive of insurance plans. This annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations, or emergency care from other providers.

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SPECIAL RULE FOR CERTAIN PAYMENTS

  (B) SPECIAL RULE FOR CERTAIN PAYMENTS OR OTHER
TRANSFERS OF VALUE.—In the case where an applicable
manufacturer provides a payment or other transfer of
value to an entity or individual at the request of or designated
on behalf of a covered recipient, the applicable
manufacturer shall disclose that payment or other transfer
of value under the name of the covered recipient.
(2) PHYSICIAN OWNERSHIP.—In addition to the requirement
under paragraph (1)(A), on March 31, 2013, and on the
90th day of each calendar year beginning thereafter, any applicable
manufacturer or applicable group purchasing organization shall submit to the Secretary, in such electronic form as
the Secretary shall require, the following information regarding
any ownership or investment interest (other than an ownership
or investment interest in a publicly traded security and
mutual fund, as described in section 1877(c)) held by a physician
(or an immediate family member of such physician (as defined
for purposes of section 1877(a))) in the applicable manufacturer
or applicable group purchasing organization during
the preceding year:
(A) The dollar amount invested by each physician
holding such an ownership or investment interest.
(B) The value and terms of each such ownership or
investment interest.
(C) Any payment or other transfer of value provided
to a physician holding such an ownership or investment interest
(or to an entity or individual at the request of or
designated on behalf of a physician holding such an ownership
or investment interest), including the information described
in clauses (i) through (viii) of paragraph (1)(A), except
that in applying such clauses, ‘physician’ shall be substituted
for ‘covered recipient’ each place it appears.
(D) Any other information regarding the ownership or
investment interest the Secretary determines appropriate.
(b) PENALTIES FOR NONCOMPLIANCE.—
(1) FAILURE TO REPORT.—
(A) IN GENERAL.—Subject to subparagraph (B) except
as provided in paragraph (2), any applicable manufacturer
or applicable group purchasing organization that fails to
submit information required under subsection (a) in a
timely manner in accordance with rules or regulations promulgated
to carry out such subsection, shall be subject to
a civil money penalty of not less than $1,000, but not more
than $10,000, for each payment or other transfer of value
or ownership or investment interest not reported as required
under such subsection. Such penalty shall be imposed
and collected in the same manner as civil money
penalties under subsection (a) of section 1128A are imposed
and collected under that section.
(B) LIMITATION.—The total amount of civil money
penalties imposed under subparagraph (A) with respect to
each annual submission of information under subsection
(a) by an applicable manufacturer or applicable group purchasing
organization shall not exceed $150,000.

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