Alert warns of Medicare conflict for concierge practices

Physicians cannot charge extra for covered services.

By Markian Hawryluk, AMNews staff. April 19, 2004.

Washington -- A new federal fraud alert highlights the fine line doctors must walk when treating Medicare patients in concierge practices.

Medicare participating physicians face potential civil monetary penalties if they charge extra for services already covered by Medicare, wrote Acting Principal Deputy Inspector General Dara Corrigan in the alert, issued March 31.

"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," Corrigan said. "Charging extra fees for already covered services abuses the trust of Medicare patients by making them pay again for services already paid for by Medicare."

The Dept. of Health and Human Services' Office of Inspector General recently alleged that R. Douglas Thorsen, MD, an internist from Minneapolis, violated his Medicare assignment agreement when he presented his patients with a medical care contract with a $600 annual fee.

The contract offered patients "coordination of care with other providers," "a comprehensive assessment and plan for optimum health," and "extra time" spent on patient care. After looking at the facts and circumstances of the case, the OIG alleged that at least some of these contracted services were already covered and reimbursable under Medicare.

The OIG stated that the physician agreed to pay an undisclosed settlement amount and to stop offering the contracts to his patients. Dr. Thorsen could not be reached for comment.