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Opinion 8.052 - Negotiating Discounts for Specialty Care

Patients are entitled to all the benefits outlined in their insurance plan. Therefore, it is unethical for a referring physician to restrict the referral options of patients who have chosen a plan that provides for access to an unlimited or broad selection of specialist physicians. It is also unethical to base the referral of these patients on a discount for the capitated patients in a primary care physician’s practice. (II)

Issued December 1997 based on the report "Ethical Issues in Negotiating Discounts for Specialty Care," adopted June 1996.