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charging a %

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best biller:
Today in a meeting with a doctor i told him that its  not legall for a provider to enter into fee splitting arrangement in NY, he answered me that it have nothing with NY state, its a national issue and in fact even the biggest billing companies like Athena health are charging a %, so its not a law to follow.

PMRNC:
Print this out for him. Indeed this is a STATE statute.  If you are a  PMRNC member you can dowload case precedences and other articles as well.  My attorney also gave me a letter which I carry in my portfolio which has this exactly for NY Physician.    Keep in mind, it's not illegal for YOU, if HE disregards the law and your contract is ever challenged, it's basically worthless (Null Void)    I do have to ask, do you have other pricing means for NY Physicians ready? If so does he have a reason for challenging it? If a provider questions me about this (I don't offer % based contracts anymore) I simply tell them I don't price that way, hand them the letter from my attorney and then I tell them the way I price comes out better for both of us.   I don't haggle over things like this, if they are just set on this I don't want a provider who's willing to disregard state laws like this. I have never had to argue, once I explain they are fine with it.   Even if it wasn't a state regulation, I would never go back to charging on a %. I like getting paid for my work.

Section 6530.19 - 19. Permitting any person to share in the fees for professional services, other than: a partner, employee, associate in a professional firm or corporation, professional subcontractor or consultant authorized to practice medicine, or a legally authorized trainee practicing under the supervision of a licensee. This prohibition shall include any arrangement or agreement whereby the amount received in payment for furnishing space, facilities, equipment or personnel services used by a licensee constitutes a percentage of, or is otherwise dependent upon,
the income or receipts of the licensee from such practice, except as otherwise provided by law with respect to a facility licensed pursuant to article twenty-eight of the public health law or article thirteen of the mental hygiene law;

best biller:
He didn't said there is not such a law.

He said that its a national law and because even such big companies like atena health are not following it its not an issue

Thanks

PMRNC:

--- Quote ---He didn't said there is not such a law.

He said that its a national law and because even such big companies like atena health are not following it its not an issue
--- End quote ---

So basically he is saying because everyone else does it it's ok. hmm  Is he giving you hard time about it?

RichardP:
Can I gently remind all of the point made starting in Paragraph 3 of this link?

http://www.medicalbillinglive.com/members/index.php?topic=7097.0

There is a distinction between a law on the books and a law that is enforced.  My experience in California is that you can find lawyers who will tell you to obey the regulation, even tho it is not being enforced by the state, and lawyers who will tell you that it is OK to ignore the regulation, because it is not being enforced.  Legally, deciding whether to obey a regulaton is a bit more complicated than just it's OK to do it because everybody else is doing it.

Having said that, I would be curious to see what national law the doctor is referring to that governs fee-splitting.  I'm not aware of anything on the national level other than the rules against self dealing that apply to doctors who accept Medicare and Medicaid patients  (Stark Law, etc.).  There may be some words about fee-splitting in these regulations, but they don't (yet) pertain to restricting how doctors can pay their billers.

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