HHS Official Warns Physicians About Additional Fees for ‘Boutique’ Care for Medicare Beneficiaries
Physicians who treat Medicare beneficiaries and charge additional fees for "boutique" care could face fines or expulsion from the program, an HHS official announced last week, the New York Times reports. Under boutique care, physicians offer patients more personalized services -- such as 24-hour access, same-day appointments and special help with referrals -- in exchange for additional fees of $500 to $20,000 per year. Dara Corrigan, acting chief of the HHS Office of Inspector General, 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." She said that physicians who charge such fees could face civil fines and that HHS could bar them from participation in Medicare, Medicaid and other federal health programs. Jennifer Leonardo, an attorney at HHS OIG, said, "Medicare regulations allow a physician to contract with beneficiaries to provide services that are truly not covered by Medicare," but not for services covered under the program. According to an American Medical Association report released last year, "No bright line separates special services and amenities from reimbursable medical services." However, the report said that when physicians sign contracts with patients, they should separate special and "reimbursable" services. Dr. John Nelson, president-elect of AMA, said that physicians should have the ability to charge additional fees for boutique care, but he added that "it must be done in such a way that I'm not double-billing or double-charging" for services. A provision in the new Medicare law calls for the General Accounting Office to review the practice of boutique care (Pear, New York Times, 4/13).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.