Guest guest Posted February 13, 2007 Report Share Posted February 13, 2007 Sami, Yes, I have known of other healthcare providers who have plead guilty to this. I am glad to see that others out there are not being hooked into thinking this is OK. I stopped discussing this with many colleagues, who would rather think that if others are doing it so can they. I did walk away from one situation like this where the two DC's wanted me to participate in this. I showed them in the chiro laws and also the medical licensure laws (regulate LAc) that this was illegal. They did agree and it changed the tone of any future negotiations. Not sure if anyone did finally join them. The penalty would depend upon regulations for your state. In MN, a practitoner can lose their license to practice as a result of the this being consider unethical or unprofessional conduct. Hope this helps and pass along the word that this is wrong. Thanks Mike W. Bowser, L Ac : herbsnacupnxr: Tue, 13 Feb 2007 20:31:18 +0000fee splitting I am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation). does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught? _______________ Get connected - Use your Hotmail address to sign into now. http://get.live.com/messenger/overview Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2007 Report Share Posted February 13, 2007 Hi Sami, Please explain. My understanding is that independent contractors pay a percentage to the business to cover overhead/expenses. Not sure if this is what you mean. It is the norm here in florida. Bob www.acuherbals.coms Sami Rank LAc <herbsnacupnxr wrote: I am so tired of all these people wanting to engage in fee splitting, though it's an illegal practice. I get job offer after job offer with percentage based payment (and generally an unfair one in my estimation). does anyone know the penalty if you get caught fee splitting? does anyone know of anyone who has gotten caught? Don't pick lemons. See all the new 2007 cars at Autos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2007 Report Share Posted February 13, 2007 Hi Mike, can you define fee-splitting for us please? Thanks, Hugo mike Bowser <naturaldoc1 Chinese Traditional Medicine Tuesday, 13 February, 2007 4:33:10 PM RE: fee splitting Sami, Yes, I have known of other healthcare providers who have plead guilty to this. I am glad to see that others out there are not being hooked into thinking this is OK. I stopped discussing this with many colleagues, who would rather think that if others are doing it so can they. I did walk away from one situation like this where the two DC's wanted me to participate in this. I showed them in the chiro laws and also the medical licensure laws (regulate LAc) that this was illegal. They did agree and it changed the tone of any future negotiations. Not sure if anyone did finally join them. The penalty would depend upon regulations for your state. In MN, a practitoner can lose their license to practice as a result of the this being consider unethical or unprofessional conduct. Hope this helps and pass along the word that this is wrong. Thanks Mike W. Bowser, L Ac herbsnacupnxr@ Tue, 13 Feb 2007 20:31:18 +0000fee splitting I am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation) . does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught? ____________ _________ _________ _________ _________ _________ _ Get connected - Use your Hotmail address to sign into now. http://get.live. com/messenger/ overview Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 as Marilyn Allen puts it, they get a percentage from you, but you don't get a percentage from them. you are not their partner. Fee splitting basically means you are paying for referrals. Sure everyone would like something for sending you patients, but legally the only compensation they should recieve is knowing they sent someone to a competent practitioner. the only legal arrangement you can make is rent, and that can include add-ons such as for the receptionist, and supplies. OR you can be their employee, if they are an MD or another acupuncturist. That means they pay you a set wage and W2 you; you are not an independant contractor that sets your own fees. Now, I know most people, especially chiropractors, try to make this percentage based arrangement, and I know most people engage in it. It makes sense in a way: you don't have patients and they do; you want to get practicing; you want to work. I know plenty of acupuncturists who engage in this situation for this very reason. they're doing ok, paying bills, and that's the point. but, it's not a legal arrangement. I want to know what the penalty is, because I think everyone who engages in this arrangement needs to know the consequences and get the kahunas to stand up for what's right and reset the standard. I keep walking away from jobs that I know could serve me, but the head of the clinic wants me to violate a law. I feel a bit like a goody-two- shoes, but they don't seem interested in other arrangements because other LAcs are Ok with it. Integrity vs income is a tricky thing... thank god I have a husband right now who wants me to take my time and stay home with our baby as much as possible so I'm in the unique position where I can walk away from jobs. Oh, one more thing, in re. to billing for units, there was an incorrect statement recently. An hour office visit is NOT 4 billable units. That is free time that you're giving away. every 15 mins you need to reinsert a needle, or flip the patient over and insert needles to bill for units... Chinese Medicine , " Bob Linde,AP, Herbalist " <boblindeherbalist wrote: > > Hi Sami, > Please explain. My understanding is that independent contractors pay a percentage to the business to cover overhead/expenses. Not sure if this is what you mean. It is the norm here in florida. > Bob > www.acuherbals.coms > > Sami Rank LAc <herbsnacupnxr wrote: > I am so tired of all these people wanting to engage in fee splitting, > though it's an illegal practice. I get job offer after job offer with > percentage based payment (and generally an unfair one in my > estimation). does anyone know the penalty if you get caught fee > splitting? does anyone know of anyone who has gotten caught? > Don't pick lemons. > See all the new 2007 cars at Autos. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Hugo, Excellent question. From the MN Bd of Medical practice, " (p) Fee splitting, including without limitation:(1) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, or remuneration, directly or indirectly, primarily for the referral of patients or the prescription of drugs or devices;(2) dividing fees with another physician or a professional corporation, unless the division is in proportion to the services provided and the responsibility assumed by each professional and the physician has disclosed the terms of the division;(3) referring a patient to any health care provider as defined in section 144.335 in which the referring physician has a " financial or economic interest, " as defined in section 144.6521, subdivision 3 , unless the physician has disclosed the physician's financial or economic interest in accordance with section 144.6521; and (4) dispensing for profit any drug or device, unless the physician has disclosed the physician's own profit interest. " I find (2) to be a little misleading and not sure that most PC actually tell the patients that they are paying a % of patient collections to the corp, which would put them at risk. Mike W. Bowser, L Ac : subincor: Tue, 13 Feb 2007 22:33:19 +0000Re: fee splitting Hi Mike, can you define fee-splitting for us please?Thanks,Hugo----- Original Message ----mike Bowser <naturaldoc1To: Chinese Traditional Medicine: Tuesday, 13 February, 2007 4:33:10 PMRE: fee splittingSami,Yes, I have known of other healthcare providers who have plead guilty to this. I am glad to see that others out there are not being hooked into thinkingthis is OK. I stopped discussing this with many colleagues, who would ratherthink that if others are doing it so can they. I did walk away from one situation like this where the two DC's wanted me to participate in this. I showed them in the chiro laws and also the medical licensure laws (regulate LAc) that this was illegal. They did agree and it changed the tone of any future negotiations. Not sure if anyone did finally join them. The penalty would depend upon regulations for your state. In MN, a practitonercan lose their license to practice as a result of the this being consider unethicalor unprofessional conduct. Hope this helps and pass along the word that this is wrong. ThanksMike W. Bowser, L AcTraditional_ Chinese_Medicine herbsnacupnxr@ Tue, 13 Feb 2007 20:31:18 +0000fee splittingI am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation) . does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught? ____________ _________ _________ _________ _________ _________ _Get connected - Use your Hotmail address to sign into now. http://get.live. com/messenger/ overview[Non-text portions of this message have been removed]<!--#ygrp-mlmsg {font-size:13px;font-family:arial,helvetica,clean,sans-serif;}#ygrp-mlmsg table {font-size:inherit;font:100%;}#ygrp-mlmsg select, input, textarea {font:99% arial,helvetica,clean,sans-serif;}#ygrp-mlmsg pre, code {font:115% monospace;}#ygrp-mlmsg * {line-height:1.22em;}#ygrp-text{font-family:Georgia;}#ygrp-text p{margin:0 0 1em 0;}#ygrp-tpmsgs{font-family:Arial;clear:both;}#ygrp-vitnav{padding-top:10px;font\ -family:Verdana;font-size:77%;margin:0;}#ygrp-vitnav a{padding:0 1px;}#ygrp-actbar{clear:both;margin:25px 0;white-space:nowrap;color:#666;text-align:right;}#ygrp-actbar ..left{float:left;white-space:nowrap;}.bld{font-weight:bold;}#ygrp-grft{font-fami\ ly:Verdana;font-size:77%;padding:15px 0;}#ygrp-ft{font-family:verdana;font-size:77%;border-top:1px solid #666;padding:5px 0;}#ygrp-mlmsg #logo{padding-bottom:10px;}#ygrp-vital{background-color:#e0ecee;margin-bottom:20\ px;padding:2px 0 8px 8px;}#ygrp-vital #vithd{font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text-transf\ orm:uppercase;}#ygrp-vital ul{padding:0;margin:2px 0;}#ygrp-vital ul li{list-style-type:none;clear:both;border:1px solid #e0ecee;}#ygrp-vital ul li ..ct{font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;paddin\ g-right:.5em;}#ygrp-vital ul li .cat{font-weight:bold;}#ygrp-vital a {text-decoration:none;}#ygrp-vital a:hover{text-decoration:underline;}#ygrp-sponsor #hd{color:#999;font-size:77%;}#ygrp-sponsor #ov{padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;}#ygrp-sponsor #ov ul{padding:0 0 0 8px;margin:0;}#ygrp-sponsor #ov li{list-style-type:square;padding:6px 0;font-size:77%;}#ygrp-sponsor #ov li a{text-decoration:none;font-size:130%;}#ygrp-sponsor #nc {background-color:#eee;margin-bottom:20px;padding:0 8px;}#ygrp-sponsor ..ad{padding:8px 0;}#ygrp-sponsor .ad #hd1{font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height\ :122%;}#ygrp-sponsor .ad a{text-decoration:none;}#ygrp-sponsor .ad a:hover{text-decoration:underline;}#ygrp-sponsor .ad p{margin:0;}o {font-size:0;}.MsoNormal {margin:0 0 0 0;}#ygrp-text tt{font-size:120%;}blockquote{margin:0 0 0 4px;}.replbq {margin:4;}-->________ New Mail is the ultimate force in competitive emailing. Find out more at the Mail Championships. Plus: play games and win prizes. http://uk.rd./evt=44106/*http://mail..net/uk [Non-text portions of this message have been removed] _______________ Get connected - Use your Hotmail address to sign into now. http://get.live.com/messenger/overview Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 you can take a % for overhead etc. Its quite common for MDs to pay a % of fees minus so called overhead. - mike Bowser Chinese Traditional Medicine Tuesday, February 13, 2007 8:12 PM RE: fee splitting Hugo, Excellent question. From the MN Bd of Medical practice, " (p) Fee splitting, including without limitation:(1) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, or remuneration, directly or indirectly, primarily for the referral of patients or the prescription of drugs or devices;(2) dividing fees with another physician or a professional corporation, unless the division is in proportion to the services provided and the responsibility assumed by each professional and the physician has disclosed the terms of the division;(3) referring a patient to any health care provider as defined in section 144.335 in which the referring physician has a " financial or economic interest, " as defined in section 144.6521, subdivision 3 , unless the physician has disclosed the physician's financial or economic interest in accordance with section 144.6521; and (4) dispensing for profit any drug or device, unless the physician has disclosed the physician's own profit interest. " I find (2) to be a little misleading and not sure that most PC actually tell the patients that they are paying a % of patient collections to the corp, which would put them at risk. Mike W. Bowser, L Ac : subincor: Tue, 13 Feb 2007 22:33:19 +0000Re: fee splitting Hi Mike, can you define fee-splitting for us please?Thanks,Hugo----- Original Message ----mike Bowser <naturaldoc1To: Chinese Traditional Medicine: Tuesday, 13 February, 2007 4:33:10 PMRE: fee splittingSami,Yes, I have known of other healthcare providers who have plead guilty to this. I am glad to see that others out there are not being hooked into thinkingthis is OK. I stopped discussing this with many colleagues, who would ratherthink that if others are doing it so can they. I did walk away from one situation like this where the two DC's wanted me to participate in this. I showed them in the chiro laws and also the medical licensure laws (regulate LAc) that this was illegal. They did agree and it changed the tone of any future negotiations. Not sure if anyone did finally join them. The penalty would depend upon regulations for your state. In MN, a practitonercan lose their license to practice as a result of the this being consider unethicalor unprofessional conduct. Hope this helps and pass along the word that this is wrong. ThanksMike W. Bowser, L AcTraditional_ Chinese_Medicine herbsnacupnxr@ Tue, 13 Feb 2007 20:31:18 +0000fee splittingI am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation) . does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught? ____________ _________ _________ _________ _________ _________ _Get connected - Use your Hotmail address to sign into now. http://get.live. com/messenger/ overview[Non-text portions of this message have been removed]<!--#y! grp-mlms g {font-size:13px;font-family:arial,helvetica,clean,sans-serif;}#ygrp-mlmsg table {font-size:inherit;font:100%;}#ygrp-mlmsg select, input, textarea {font:99% arial,helvetica,clean,sans-serif;}#ygrp-mlmsg pre, code {font:115% monospace;}#ygrp-mlmsg * {line-height:1.22em;}#ygrp-text{font-family:Georgia;}#ygrp-text p{margin:0 0 1em 0;}#ygrp-tpmsgs{font-family:Arial;clear:both;}#ygrp-vitnav{padding-top:10px;font\ -family:Verdana;font-size:77%;margin:0;}#ygrp-vitnav a{padding:0 1px;}#ygrp-actbar{clear:both;margin:25px 0;white-space:nowrap;color:#666;text-align:right;}#ygrp-actbar ..left{float:left;white-space:nowrap;}.bld{font-weight:bold;}#ygrp-grft{font-fami\ ly:Verdana;font-size:77%;padding:15px 0;}#ygrp-ft{font-family:verdana;font-size:77%;border-top:1px solid #666;padding:5px 0;}#ygrp-mlmsg #logo{padding-bottom:10px;}#ygrp-vital{background-color:#e0ecee;margin-bottom:20\ px;padding:2px 0 8px 8px;}#ygrp-vital #vithd{font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text-transf\ orm:uppercase;}#ygrp-vital ul{padding:0;margin:2px 0;}#ygrp-vital ul li{list-style-type:none;clear:both;border:1px solid #e0ecee;}#ygrp-vital ul li ..ct{font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;paddin\ g-right:.5em;}#ygrp-vital ul li .cat{font-weight:bold;}#ygrp-vital a {text-decoration:none;}#ygrp-vital a:hover{text-decoration:underline;}#ygrp-sponsor #hd{color:#999;font-size:77%;}#ygrp-sponsor #ov{padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;}#ygrp-sponsor #ov ul{padding:0 0 0 8px;margin:0;}#ygrp-sponsor #ov li{list-style-type:square;! pad ding:6px 0;font-size:77%;}#ygrp-sponsor #ov li a{text-decoration:none;font-size:130%;}#ygrp-sponsor #nc {background-color:#eee;margin-bottom:20px;padding:0 8px;}#ygrp-sponsor ..ad{padding:8px 0;}#ygrp-sponsor .ad #hd1{font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height\ :122%;}#ygrp-sponsor .ad a{text-decoration:none;}#ygrp-sponsor .ad a:hover{text-decoration:underline;}#ygrp-sponsor .ad p{margin:0;}o {font-size:0;}.MsoNormal {margin:0 0 0 0;}#ygrp-text tt{font-size:120%;}blockquote{margin:0 0 0 4px;}.replbq {margin:4;}-->________ New Mail is the ultimate force in competitive emailing. Find out more at the Mail Championships. Plus: play games and win prizes. http://uk.rd./evt=44106/*http://mail..net/uk [Non-text portions of this message have been removed] ________ Get connected - Use your Hotmail address to sign into now. http://get.live.com/messenger/overview Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 I would suggest a good attorney to clarify this issue. When a practitioner pays a % of their patient fees, they are engaging in fee splitting. This does not need to be necessarily with another practitioner. I have run across an interesting twist on this as a chiro corp got into trouble when they hired some foreigners to act as interpreters/taxi drivers. The DC's plead guilty and got a reduction in sentence. Independent contractors are supposed to pay rent, not a % of collections. One is an independent fixed cost that is separate from collections and the other is tied into it. By being tied to it, you run into difficulty showing that these two are separate entities. Acupuncturetoday.com ran an excellent article (archives) by Dr. McNamee (DC/LAc) on independent contractor vs. employee. What tends to happen a lot is that step into situations where a landlord is telling us how it is and we assume it is legal and correct. From the article, you can see that things need to line up in one column or the other and not pick things from both. These two areas are important and often interconnected but seldom do we hear them discussed. I hope that we can change this. Forgot to add that if you get caught fee splitting, it will depend upon your licensing board and they could take your license or suspend it. Most likely the other party will not be penalized, unless they also violated the IRS criteria for independent contractors (unpaid taxes and penalties for such can add up) and they could be closed down until they pay. Mike W. Bowser, L Ac : boblindeherbalist: Tue, 13 Feb 2007 13:54:57 -0800Re: TCM - fee splitting Hi Sami,Please explain. My understanding is that independent contractors pay a percentage to the business to cover overhead/expenses. Not sure if this is what you mean. It is the norm here in florida.Bobwww.acuherbals.comsSami Rank LAc <herbsnacupnxr wrote:I am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation). does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught?Don't pick lemons.See all the new 2007 cars at Autos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Yes Alon but many of them belong to a PC (business entity) and therefore things are a lot different. Mike W. Bowser, L Ac : alonmarcus: Tue, 13 Feb 2007 20:29:12 -0800Re: fee splitting you can take a % for overhead etc. Its quite common for MDs to pay a % of fees minus so called overhead.Oakland CA 94609- mike Bowser Chinese Traditional Medicine Sent: Tuesday, February 13, 2007 8:12 PMRE: fee splittingHugo,Excellent question. From the MN Bd of Medical practice, " (p) Fee splitting, including without limitation:(1) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, or remuneration, directly or indirectly, primarily for the referral of patients or the prescription of drugs or devices;(2) dividing fees with another physician or a professional corporation, unless the division is in proportion to the services provided and the responsibility assumed by each professional and the physician has disclosed the terms of the division;(3) referring a patient to any health care provider as defined in section 144.335 in which the referring physician has a " financial or economic interest, " as defined in section 144.6521, subdivision 3 , unless the physician has disclosed the physician's financial or economic interest in accordance with section 144.6521; and (4) dispensing for profit any drug or device, unless the physician has disclosed the physician's own profit interest. " I find (2) to be a little misleading and not sure that most PC actually tell the patients that theyare paying a % of patient collections to the corp, which would put them at risk. Mike W. Bowser, L AcTo: Chinese Medicine: subincor: Tue, 13 Feb 2007 22:33:19 +0000Re: fee splittingHi Mike, can you define fee-splitting for us please?Thanks,Hugo mike Bowser <naturaldoc1To: Chinese Traditional Medicine: Tuesday, 13 February, 2007 4:33:10 PMRE: fee splittingSami,Yes, I have known of other healthcare providers who have plead guilty to this. I am glad to see that others out there are not being hooked into thinkingthis is OK. I stopped discussing this with many colleagues, who would ratherthink that if others are doing it so can they. I did walk away from one situation like this where the two DC's wanted me to participate in this. I showed them in the chiro laws and also the medical licensure laws (regulate LAc) that this was illegal. They did agree and it changed the tone of any future negotiations. Not sure if anyone did finally join them. The penalty would depend upon regulations for your state. In MN, a practitonercan lose their license to practice as a result of the this being consider unethicalor unprofessional conduct. Hope this helps and pass along the word that this is wrong. ThanksMike W. Bowser, L AcTraditional_ Chinese_Medicine herbsnacupnxr@ Tue, 13 Feb 2007 20:31:18 +0000fee splittingI am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation) . does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught? ____________ _________ _________ _________ _________ _________ _Get connected - Use your Hotmail address to sign into now. http://get.live. com/messenger/ overview[Non-text portions of this message have been removed]<!--#y! grp-mlms g {font-size:13px;font-family:arial,helvetica,clean,sans-serif;}#ygrp-mlmsg table {font-size:inherit;font:100%;}#ygrp-mlmsg select, input, textarea {font:99% arial,helvetica,clean,sans-serif;}#ygrp-mlmsg pre, code {font:115% monospace;}#ygrp-mlmsg * {line-height:1.22em;}#ygrp-text{font-family:Georgia;}#ygrp-text p{margin:0 0 1em 0;}#ygrp-tpmsgs{font-family:Arial;clear:both;}#ygrp-vitnav{padding-top:10px;font\ -family:Verdana;font-size:77%;margin:0;}#ygrp-vitnav a{padding:0 1px;}#ygrp-actbar{clear:both;margin:25px 0;white-space:nowrap;color:#666;text-align:right;}#ygrp-actbar ..left{float:left;white-space:nowrap;}.bld{font-weight:bold;}#ygrp-grft{font-fami\ ly:Verdana;font-size:77%;padding:15px 0;}#ygrp-ft{font-family:verdana;font-size:77%;border-top:1px solid #666;padding:5px 0;}#ygrp-mlmsg #logo{padding-bottom:10px;}#ygrp-vital{background-color:#e0ecee;margin-bottom:20\ px;padding:2px 0 8px 8px;}#ygrp-vital #vithd{font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text-transf\ orm:uppercase;}#ygrp-vital ul{padding:0;margin:2px 0;}#ygrp-vital ul li{list-style-type:none;clear:both;border:1px solid #e0ecee;}#ygrp-vital ul li ..ct{font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;paddin\ g-right:.5em;}#ygrp-vital ul li .cat{font-weight:bold;}#ygrp-vital a {text-decoration:none;}#ygrp-vital a:hover{text-decoration:underline;}#ygrp-sponsor #hd{color:#999;font-size:77%;}#ygrp-sponsor #ov{padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;}#ygrp-sponsor #ov ul{padding:0 0 0 8px;margin:0;}#ygrp-sponsor #ov li{list-style-type:square;! pad ding:6px 0;font-size:77%;}#ygrp-sponsor #ov li a{text-decoration:none;font-size:130%;}#ygrp-sponsor #nc {background-color:#eee;margin-bottom:20px;padding:0 8px;}#ygrp-sponsor ..ad{padding:8px 0;}#ygrp-sponsor .ad #hd1{font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height\ :122%;}#ygrp-sponsor .ad a{text-decoration:none;}#ygrp-sponsor .ad a:hover{text-decoration:underline;}#ygrp-sponsor .ad p{margin:0;}o {font-size:0;}.MsoNormal {margin:0 0 0 0;}#ygrp-text tt{font-size:120%;}blockquote{margin:0 0 0 4px;}.replbq {margin:4;}-->________ New Mail is the ultimate force in competitive emailing. Find out more at the Mail Championships. Plus: play games and win prizes. http://uk.rd./evt=44106/*http://mail..net/uk [Non-text portions of this message have been removed] ________Get connected - Use your Hotmail address to sign into now. http://get.live.com/messenger/overview[Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Mike If a PC are they still an independent contractor? I wander why a PC can do it as it is still a % reduction of fees - mike Bowser Chinese Traditional Medicine Tuesday, February 13, 2007 8:41 PM RE: fee splitting Yes Alon but many of them belong to a PC (business entity) and therefore things are a lot different. Mike W. Bowser, L Ac : alonmarcus: Tue, 13 Feb 2007 20:29:12 -0800Re: fee splitting you can take a % for overhead etc. Its quite common for MDs to pay a % of fees minus so called overhead.Oakland CA 94609- mike Bowser Chinese Traditional Medicine Sent: Tuesday, February 13, 2007 8:12 PMRE: fee splittingHugo,Excellent question. From the MN Bd of Medical practice, " (p) Fee splitting, including without limitation:(1) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, or remuneration, directly or indirectly, primarily for the referral of patients or the prescription of drugs or devices;(2) dividing fees with another physician or a professional corporation, unless the division is in proportion to the services provided and the responsibility assumed by each professional and the physician has disclosed the terms of the division;(3) referring a patient to any health care provider as defined in section 144.335 in which the referring physician has a " financial or economic interest, " as defined in section 144.6521, subdivision 3 , unless the physician has disclosed the physician's financial or economic interest in accordance with section 144.6521; and (4) dispensing for profit any drug or device, unless the physician has disclosed the physician's own profit interest. " I find (2) to be a little misleading and not sure that most PC actually tell the patients that theyare paying a % of patient collections to the corp, which would put them at risk. Mike W. Bowser, L AcTo: Chinese Medicine: subincor: Tue, 13 Feb 2007 22:33:19 +0000Re: fee splittingHi Mike, can you define fee-splitting for us please?Th! anks,Hugo mike Bowser <naturaldoc1To: Chinese Traditional Medicine: Tuesday, 13 February, 2007 4:33:10 PMRE: fee splittingSami,Yes, I have known of other healthcare providers who have plead guilty to this. I am glad to see that others out there are not being hooked into thinkingthis is OK. I stopped discussing this with many colleagues, who would ratherthink that if others are doing it so can they. I did walk away from one situation like this where the two DC's wanted me to participate in this. I showed them in the chiro laws and also the medical licensure laws (regulate LAc) that this was illegal. They did agree and it changed the tone of any future negotiations. Not sure if anyone did finally join them. The penalty would depend upon regulations for your state. In MN, a practitonercan lose their license to practice as a result of the this being consider unethicalor unprofessional conduct. Hope this helps and pass along the word that this is wrong. ThanksMike W. Bowser, L AcTraditional_ Chinese_Medicine herbsnacupnxr@ Tue, 13 Feb 2007 20:31:18 +0000fee splittingI am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation) . does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught? ____________ _________ _________ _________ _________ _________ _Get connected - Use your Hotmail address to sign into now. http://get.live. com/messenger/ overview[Non-text portions of this message have been removed]<!--#y! grp-mlms g {font-size:13px;font-family:arial,helve! tica,clean,sans-serif;}#ygrp-mlmsg table {font-size:inherit;font:100%;}#ygrp-mlmsg select, input, textarea {font:99% arial,helvetica,clean,sans-serif;}#ygrp-mlmsg pre, code {font:115% monospace;}#ygrp-mlmsg * {line-height:1.22em;}#ygrp-text{font-family:Georgia;}#ygrp-text p{margin:0 0 1em 0;}#ygrp-tpmsgs{font-family:Arial;clear:both;}#ygrp-vitnav{padding-top:10px;font\ -family:Verdana;font-size:77%;margin:0;}#ygrp-vitnav a{padding:0 1px;}#ygrp-actbar{clear:both;margin:25px 0;white-space:nowrap;color:#666;text-align:right;}#ygrp-actbar ..left{float:left;white-space:nowrap;}.bld{font-weight:bold;}#ygrp-grft{font-fami\ ly:Verdana;font-size:77%;padding:15px 0;}#ygrp-ft{font-family:verdana;font-size:77%;border-top:1px solid #666;padding:5px 0;}#ygrp-mlmsg #logo{padding-bottom:10px;}#ygrp-vital{background-color:#e0ecee;margin-bottom:20\ px;padding:2px 0 8px 8px;}#ygrp-vital #vithd{font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text-transf\ orm:uppercase;}#ygrp-vital ul{padding:0;margin:2px 0;}#ygrp-vital ul li{list-style-type:none;clear:both;border:1px solid #e0ecee;}#ygrp-vital ul li ..ct{font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;paddin\ g-right:.5em;}#ygrp-vital ul li .cat{font-weight:bold;}#ygrp-vital a {text-decoration:none;}#ygrp-vital a:hover{text-decoration:underline;}#ygrp-sponsor #hd{color:#999;font-size:77%;}#ygrp-sponsor #ov{padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;}#ygrp-sponsor #ov ul{padding:0 0 0 8px;margin:0;}#ygrp-sponsor #ov li{list-style-type:square;! pad ding:6px 0;font-size:77%;}#ygrp-sponso! r #ov li a{text-decoration:none;font-size:130%;}#ygrp-sponsor #nc {background-color:#eee;margin-bottom:20px;padding:0 8px;}#ygrp-sponsor ..ad{padding:8px 0;}#ygrp-sponsor .ad #hd1{font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height\ :122%;}#ygrp-sponsor .ad a{text-decoration:none;}#ygrp-sponsor .ad a:hover{text-decoration:underline;}#ygrp-sponsor .ad p{margin:0;}o {font-size:0;}.MsoNormal {margin:0 0 0 0;}#ygrp-text tt{font-size:120%;}blockquote{margin:0 0 0 4px;}.replbq {margin:4;}-->________ New Mail is the ultimate force in competitive emailing. 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Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Sami, Mike, et al: I guess I am confused. The words fee splitting say to me that someone referrred you a patient an then you gave them 20% of the fee. This I have always heard was illegal in my state MD and I'm sure many others. Now, independent contractor. That seems like an IRS issue. I didn't read the AT article but have seen the criteria before. If you fall into an IC criteria, why wouldn't this be legal. Massage therapists do this all the time, I have heard acupuncturists who are running wellness clinics do this, my dentist does this with her associate. The associate gets 30% of the fees she brings in. Sounds low, and for us or massage it is. But for denstistry when services are so much higher, that is what they came up with. This IC arrangement seems perfectly legal to me. Rent is very different. I am paying it now. I was sick yesterday, had to cancel my patients. I still pay rent. We are having an ice strorm today. Most patients won't come. I still pay rent. If I was an IC, my overhead charges would be 0 on these two days. Anne -------------- Original message ---------------------- " Sami Rank LAc " <herbsnacupnxr > as Marilyn Allen puts it, they get a percentage from you, but you > don't get a percentage from them. you are not their partner. Fee > splitting basically means you are paying for referrals. Sure everyone > would like something for sending you patients, but legally the only > compensation they should recieve is knowing they sent someone to a > competent practitioner. the only legal arrangement you can make is > rent, and that can include add-ons such as for the receptionist, and > supplies. OR you can be their employee, if they are an MD or another > acupuncturist. That means they pay you a set wage and W2 you; you are > not an independant contractor that sets your own fees. > > Now, I know most people, especially chiropractors, try to make this > percentage based arrangement, and I know most people engage in it. It > makes sense in a way: you don't have patients and they do; you want to > get practicing; you want to work. I know plenty of acupuncturists who > engage in this situation for this very reason. they're doing ok, > paying bills, and that's the point. but, it's not a legal arrangement. > > I want to know what the penalty is, because I think everyone who > engages in this arrangement needs to know the consequences and get the > kahunas to stand up for what's right and reset the standard. I keep > walking away from jobs that I know could serve me, but the head of the > clinic wants me to violate a law. I feel a bit like a goody-two- > shoes, but they don't seem interested in other arrangements because > other LAcs are Ok with it. Integrity vs income is a tricky thing... > thank god I have a husband right now who wants me to take my time and > stay home with our baby as much as possible so I'm in the unique > position where I can walk away from jobs. > > Oh, one more thing, in re. to billing for units, there was an > incorrect statement recently. An hour office visit is NOT 4 billable > units. That is free time that you're giving away. every 15 mins you > need to reinsert a needle, or flip the patient over and insert needles > to bill for units... > > > > > > Chinese Medicine , " Bob Linde,AP, > Herbalist " <boblindeherbalist wrote: > > > > Hi Sami, > > Please explain. My understanding is that independent contractors > pay a percentage to the business to cover overhead/expenses. Not sure > if this is what you mean. It is the norm here in florida. > > Bob > > www.acuherbals.coms > > > > Sami Rank LAc <herbsnacupnxr wrote: > > I am so tired of all these people wanting to engage in fee > splitting, > > though it's an illegal practice. I get job offer after job offer with > > percentage based payment (and generally an unfair one in my > > estimation). does anyone know the penalty if you get caught fee > > splitting? does anyone know of anyone who has gotten caught? > > > > > > > > > > > > > > > > Don't pick lemons. > > See all the new 2007 cars at Autos. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 so if I charge other clinicians a % of their take for rent, that's fee splitting? karen mike Bowser wrote: > I would suggest a good attorney to clarify this issue. When a > practitioner pays a % of > their patient fees, they are engaging in fee splitting. This does not > need to be necessarily > with another practitioner. I have run across an interesting twist on > this as a chiro corp > got into trouble when they hired some foreigners to act as > interpreters/taxi drivers. The > DC's plead guilty and got a reduction in sentence. > > Independent contractors are supposed > to pay rent, not a % of collections. One is an independent fixed cost > that is separate > from collections and the other is tied into it. By being tied to it, > you run into difficulty > showing that these two are separate entities. > > Acupuncturetoday.com ran an excellent > article (archives) by Dr. McNamee (DC/LAc) on independent contractor > vs. employee. > What tends to happen a lot is that step into situations where a > landlord is telling us how > it is and we assume it is legal and correct. From the article, you can > see that things need > to line up in one column or the other and not pick things from both. > These two areas > are important and often interconnected but seldom do we hear them > discussed. I hope > that we can change this. > > Forgot to add that if you get caught fee splitting, it will depend > upon your licensing board > and they could take your license or suspend it. Most likely the other > party will not be > penalized, unless they also violated the IRS criteria for independent > contractors (unpaid taxes > and penalties for such can add up) and they could be closed down until > they pay. Mike W. Bowser, L Ac > > > <Chinese Medicine%40From>: > boblindeherbalist > <boblindeherbalist%40Date>: Tue, 13 Feb 2007 13:54:57 > -0800Re: fee splitting > > Hi Sami,Please explain. My understanding is that independent > contractors pay a percentage to the business to cover > overhead/expenses. Not sure if this is what you mean. It is the norm > here in florida.Bobwww.acuherbals.comsSami Rank LAc > <herbsnacupnxr <herbsnacupnxr%40>> wrote:I > am so tired of all these people wanting to engage in fee > splitting,though it's an illegal practice. I get job offer after job > offer withpercentage based payment (and generally an unfair one in > myestimation). does anyone know the penalty if you get caught > feesplitting? does anyone know of anyone who has gotten > caught?Don't pick lemons.See all the > new 2007 cars at Autos.[Non-text portions of this message have > been removed] > > ________ > Live Search: Better results, fast > http://get.live.com/search/overview <http://get.live.com/search/overview> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 yes > so if I charge other clinicians a % of their take for rent, that's fee > splitting? > karen > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 One thing Marilyn Allen suggests is that you engage in this relationship no more than 6 mos, then switch, pre-arranged of course, to rent, which naturally would include reception, etc. It's not that she suggests it at all, just as an option should the head practice person insist. If they insist beyond that period, all are at risk of violation. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Karen, That is how I read things. I use the guide that if a rent is contingent upon someone else's collections, this drives up healthcare costs and is simply fee splitting. Your fees x % of collections = rent seems illogical, no? I would think an hourly rate (like $10 or $15/patient hr) would be Ok as it does not tie collections with rent but usage of the space. This might be a technicality but I happen to think it makes sense. Maybe an attorney can chime in on this. Mike W. Bowser, L Ac : tryfan: Wed, 14 Feb 2007 09:43:36 -0500Re: fee splitting so if I charge other clinicians a % of their take for rent, that's fee splitting?karenmike Bowser wrote:> I would suggest a good attorney to clarify this issue. When a > practitioner pays a % of> their patient fees, they are engaging in fee splitting. This does not > need to be necessarily> with another practitioner. I have run across an interesting twist on > this as a chiro corp> got into trouble when they hired some foreigners to act as > interpreters/taxi drivers. The> DC's plead guilty and got a reduction in sentence.>> Independent contractors are supposed> to pay rent, not a % of collections. One is an independent fixed cost > that is separate> from collections and the other is tied into it. By being tied to it, > you run into difficulty> showing that these two are separate entities.>> Acupuncturetoday.com ran an excellent> article (archives) by Dr. McNamee (DC/LAc) on independent contractor > vs. employee.> What tends to happen a lot is that step into situations where a > landlord is telling us how> it is and we assume it is legal and correct. From the article, you can > see that things need> to line up in one column or the other and not pick things from both. > These two areas> are important and often interconnected but seldom do we hear them > discussed. I hope> that we can change this.>> Forgot to add that if you get caught fee splitting, it will depend > upon your licensing board> and they could take your license or suspend it. Most likely the other > party will not be> penalized, unless they also violated the IRS criteria for independent > contractors (unpaid taxes> and penalties for such can add up) and they could be closed down until > they pay. Mike W. Bowser, L Ac>> To: Chinese Medicine > <Chinese Medicine%40From>: > boblindeherbalist > <boblindeherbalist%40Date>: Tue, 13 Feb 2007 13:54:57 > -0800Re: fee splitting>> Hi Sami,Please explain. My understanding is that independent > contractors pay a percentage to the business to cover > overhead/expenses. Not sure if this is what you mean. It is the norm > here in florida.Bobwww.acuherbals.comsSami Rank LAc > <herbsnacupnxr <herbsnacupnxr%40>> wrote:I > am so tired of all these people wanting to engage in fee > splitting,though it's an illegal practice. I get job offer after job > offer withpercentage based payment (and generally an unfair one in > myestimation). does anyone know the penalty if you get caught > feesplitting? does anyone know of anyone who has gotten > caught?Don't pick lemons.See all the > new 2007 cars at Autos.[Non-text portions of this message have > been removed]>> ________> Live Search: Better results, fast> http://get.live.com/search/overview <http://get.live.com/search/overview>>> [Non-text portions of this message have been removed]>> >>------------------------->>No virus found in this incoming message.>>Version: 7.5.441 / Virus Database: 268.17.36/681 - Release 11/02/2007 18:50> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Anne,First question, why are you paying rent? While yes many definitions for fee splitting do cite the concept of paymentfor referral, many others (including a recent court case against a MN chiro corp) did prosecute for payment to immigrants for taxi/language services as partof fee splitting. Apparently the compensation was set up to be a % of collections. So, I think it is safe to assume that any payments for any referralsis a no-no. The other part of this is when we tie collections to rent. Have you considered how much more you will pay for this even w/o consideringthe % collections legality issue? You will pay a lot more. The IRS is the one that determines how a IC is to operate and many of ussometimes do not realize that you conduct your own business (own hours,own fees, etc). There should not be a blending of yours and their businesses.You are incorrect about your overhead charges for lost storm days. You assumethe risks. I would like to point out that the medical professionals do sometimes deal in %for their physicians but that these groups also have legal entities or PC that allowfor them to do so. Also think we need to remember that we are not MT even though these arrangements do seem to violate the IRS common law criteria. I suggest you read the article and review the chart at http://www.acupuncturetoday.com/mpacms/at/article.php?id=28108 as this might help to answer some of these questions. Please note that he agrees that you assume the risk for patients not showing up. Please remember that just because several people are doing something, it is not a legal OK to participate. I am undertaking chiro college currently and can tell you that there are many opinions about some of these issues, which is why I would stay on the straight and narrow and not jeopardize my practice by tying it to anyone else's nor would I consider arrangements that could be scrutinized as questionable. In my father's day, these things were never done in his dental practice or the profession at large. These are new ideas and many of them have not withstood a legal challenge. Mike W. Bowser, L Ac : anne.crowley: Wed, 14 Feb 2007 14:06:17 +0000Re: TCM - fee splitting Sami, Mike, et al:I guess I am confused. The words fee splitting say to me that someone referrred you a patient an then you gave them 20% of the fee. This I have always heard was illegal in my state MD and I'm sure many others.Now, independent contractor. That seems like an IRS issue. I didn't read the AT article but have seen the criteria before. If you fall into an IC criteria, why wouldn't this be legal. Massage therapists do this all the time, I have heard acupuncturists who are running wellness clinics do this, my dentist does this with her associate. The associate gets 30% of the fees she brings in. Sounds low, and for us or massage it is. But for denstistry when services are so much higher, that is what they came up with.This IC arrangement seems perfectly legal to me.Rent is very different. I am paying it now. I was sick yesterday, had to cancel my patients. I still pay rent. We are having an ice strorm today. Most patients won't come. I still pay rent. If I was an IC, my overhead charges would be 0 on these two days.Anne-------------- Original message ---------------------- " Sami Rank LAc " <herbsnacupnxr> as Marilyn Allen puts it, they get a percentage from you, but you> don't get a percentage from them. you are not their partner. Fee> splitting basically means you are paying for referrals. Sure everyone> would like something for sending you patients, but legally the only> compensation they should recieve is knowing they sent someone to a> competent practitioner. the only legal arrangement you can make is> rent, and that can include add-ons such as for the receptionist, and> supplies. OR you can be their employee, if they are an MD or another> acupuncturist. That means they pay you a set wage and W2 you; you are> not an independant contractor that sets your own fees.> > Now, I know most people, especially chiropractors, try to make this> percentage based arrangement, and I know most people engage in it. It> makes sense in a way: you don't have patients and they do; you want to> get practicing; you want to work. I know plenty of acupuncturists who> engage in this situation for this very reason. they're doing ok,> paying bills, and that's the point. but, it's not a legal arrangement. > > I want to know what the penalty is, because I think everyone who> engages in this arrangement needs to know the consequences and get the> kahunas to stand up for what's right and reset the standard. I keep> walking away from jobs that I know could serve me, but the head of the> clinic wants me to violate a law. I feel a bit like a goody-two-> shoes, but they don't seem interested in other arrangements because> other LAcs are Ok with it. Integrity vs income is a tricky thing...> thank god I have a husband right now who wants me to take my time and> stay home with our baby as much as possible so I'm in the unique> position where I can walk away from jobs.> > Oh, one more thing, in re. to billing for units, there was an> incorrect statement recently. An hour office visit is NOT 4 billable> units. That is free time that you're giving away. every 15 mins you> need to reinsert a needle, or flip the patient over and insert needles> to bill for units...> > > > > > Chinese Medicine , " Bob Linde,AP,> Herbalist " <boblindeherbalist wrote:> >> > Hi Sami,> > Please explain. My understanding is that independent contractors> pay a percentage to the business to cover overhead/expenses. Not sure> if this is what you mean. It is the norm here in florida.> > Bob> > www.acuherbals.coms> > > > Sami Rank LAc <herbsnacupnxr wrote:> > I am so tired of all these people wanting to engage in fee> splitting,> > though it's an illegal practice. I get job offer after job offer with> > percentage based payment (and generally an unfair one in my> > estimation). does anyone know the penalty if you get caught fee> > splitting? does anyone know of anyone who has gotten caught?> > > > > > > > > > > > > > > > Don't pick lemons.> > See all the new 2007 cars at Autos.> > > > [Non-text portions of this message have been removed]> >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Here is the catch with fee splitting and paying your landlord a %. If this person (physician or not) recommends someone to go see you then they can be in trouble (fee splitting). There is so much to this and many other business issues that it really speaks to an overall professional problem or lack of business understanding. You are right on with your understanding. Just curious as to where did you learn this as most in the profession do get this area of practice covered.Mike W. Bowser, L Ac : herbsnacupnxr: Wed, 14 Feb 2007 02:06:31 +0000Re: TCM - fee splitting as Marilyn Allen puts it, they get a percentage from you, but youdon't get a percentage from them. you are not their partner. Feesplitting basically means you are paying for referrals. Sure everyonewould like something for sending you patients, but legally the onlycompensation they should recieve is knowing they sent someone to acompetent practitioner. the only legal arrangement you can make isrent, and that can include add-ons such as for the receptionist, andsupplies. OR you can be their employee, if they are an MD or anotheracupuncturist. That means they pay you a set wage and W2 you; you arenot an independant contractor that sets your own fees.Now, I know most people, especially chiropractors, try to make thispercentage based arrangement, and I know most people engage in it. Itmakes sense in a way: you don't have patients and they do; you want toget practicing; you want to work. I know plenty of acupuncturists whoengage in this situation for this very reason. they're doing ok,paying bills, and that's the point. but, it's not a legal arrangement. I want to know what the penalty is, because I think everyone whoengages in this arrangement needs to know the consequences and get thekahunas to stand up for what's right and reset the standard. I keepwalking away from jobs that I know could serve me, but the head of theclinic wants me to violate a law. I feel a bit like a goody-two-shoes, but they don't seem interested in other arrangements becauseother LAcs are Ok with it. Integrity vs income is a tricky thing...thank god I have a husband right now who wants me to take my time andstay home with our baby as much as possible so I'm in the uniqueposition where I can walk away from jobs.Oh, one more thing, in re. to billing for units, there was anincorrect statement recently. An hour office visit is NOT 4 billableunits. That is free time that you're giving away. every 15 mins youneed to reinsert a needle, or flip the patient over and insert needlesto bill for units...Chinese Medicine , " Bob Linde,AP,Herbalist " <boblindeherbalist wrote:>> Hi Sami,> Please explain. My understanding is that independent contractorspay a percentage to the business to cover overhead/expenses. Not sureif this is what you mean. It is the norm here in florida.> Bob> www.acuherbals.coms> > Sami Rank LAc <herbsnacupnxr wrote:> I am so tired of all these people wanting to engage in feesplitting,> though it's an illegal practice. I get job offer after job offer with> percentage based payment (and generally an unfair one in my> estimation). does anyone know the penalty if you get caught fee> splitting? does anyone know of anyone who has gotten caught?> > > > > > > > Don't pick lemons.> See all the new 2007 cars at Autos.> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Hi Karen karen <tryfan wrote: so if I charge other clinicians a % of their take for rent, that's fee splitting? karen It's not easy to find much written specifically by acupuncture professionals...but other health care pros clearly come down against this practice fee splitting n. The practice of sharing fees with professional colleagues, such as physicians, for patient or client referrals. http://pn.psychiatryonline.org/cgi/content/full/38/1/35 excerpt: Richard D. Milone, M.D. and Wade C. Myers, M.D. chair and vice chair, respectively, of APA’s Ethics Committee, respond: This [practitioner] has questioned whether it truly constitutes fee splitting for a [practitioner] to rent space in exchange for office space, secretarial services, and other administrative support...[and] have this person pay him or her a percentage of the fees generated from patients and third-party payers...APA, through the Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry, Section 2, Annotation 7, has clearly defined this practice as fee splitting. Instead, the arrangement should be a mutually agreed-upon set fee for administrative support services... This policy is to help ensure a climate in which [practitioners] deal honestly with patients and to safeguard against the conflict of interest inherent in an arrangement whereby a [practitioner] will monetarily benefit from every referral he or she makes to the contracted partner. http://www.ama-assn.org/ama/pub/category/8365.html excerpt: Payment by or to a physician solely for the referral of a patient is fee splitting and is unethical... A physician may not accept payment of any kind, in any form, from any source, ....for referring a patient to said source. In each case, the payment violates the requirement to deal honestly with patients and colleagues... So, as many have stated, just because some do it...doesn't mean that it's legal and surely doesn't mean that it is ethical There are even companies whose marketing plan is based on fee splitting and are facing legal challenges as in the Chiro industry where both in New York and Illinois the contracts for marketing have been deemed void as they violate this law. http://www.chiroweb.com/archives/09/14/03.html the Oregon Board of Chiropractic Examiners have also come down against the legality of this issue www.oregon.gov/OBCE/pdfs/ABS_Marketing.pdf If someone is letting you keep a (usually small) percent of YOUR work..are you being treated as an equal? a colleague? Stephen Woodley LAc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2007 Report Share Posted February 14, 2007 Alon, Not sure about your question as I think that they are considered associates (not sure what this would translate in tax terms). Good question for an attorney. Maybe they can do it as they are really employee/part owner. Hospitals may also be this way. Mike W. Bowser, L Ac : alonmarcus: Tue, 13 Feb 2007 21:15:42 -0800Re: fee splitting MikeIf a PC are they still an independent contractor? I wander why a PC can do it as it is still a % reduction of fees Oakland CA 94609----- Original Message ----- mike Bowser Chinese Traditional Medicine Sent: Tuesday, February 13, 2007 8:41 PMRE: fee splittingYes Alon but many of them belong to a PC (business entity) and therefore thingsare a lot different. Mike W. Bowser, L AcTo: Chinese Medicine: alonmarcus: Tue, 13 Feb 2007 20:29:12 -0800Re: fee splittingyou can take a % for overhead etc. Its quite common for MDs to pay a % of fees minus so called overhead.Oakland CA 94609- mike Bowser Chinese Traditional Medicine Sent: Tuesday, February 13, 2007 8:12 PMRE: fee splittingHugo,Excellent question. From the MN Bd of Medical practice, " (p) Fee splitting, including without limitation:(1) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, or remuneration, directly or indirectly, primarily for the referral of patients or the prescription of drugs or devices;(2) dividing fees with another physician or a professional corporation, unless the division is in proportion to the services provided and the responsibility assumed by each professional and the physician has disclosed the terms of the division;(3) referring a patient to any health care provider as defined in section 144.335 in which the referring physician has a " financial or economic interest, " as defined in section 144.6521, subdivision 3 , unless the physician has disclosed the physician's financial or economic interest in accordance with section 144.6521; and (4) dispensing for profit any drug or device, unless the physician has disclosed the physician's own profit interest. " I find (2) to be a little misleading and not sure that most PC actually tell the patients that theyare paying a % of patient collections to the corp, which would put them at risk. Mike W. Bowser, L AcTo: Chinese Medicine: subincor: Tue, 13 Feb 2007 22:33:19 +0000Re: fee splittingHi Mike, can you define fee-splitting for us please?Th! anks,Hugo mike Bowser <naturaldoc1To: Chinese Traditional Medicine: Tuesday, 13 February, 2007 4:33:10 PMRE: fee splittingSami,Yes, I have known of other healthcare providers who have plead guilty to this. I am glad to see that others out there are not being hooked into thinkingthis is OK. I stopped discussing this with many colleagues, who would ratherthink that if others are doing it so can they. I did walk away from one situation like this where the two DC's wanted me to participate in this. I showed them in the chiro laws and also the medical licensure laws (regulate LAc) that this was illegal. They did agree and it changed the tone of any future negotiations. Not sure if anyone did finally join them. The penalty would depend upon regulations for your state. In MN, a practitonercan lose their license to practice as a result of the this being consider unethicalor unprofessional conduct. Hope this helps and pass along the word that this is wrong. ThanksMike W. Bowser, L AcTraditional_ Chinese_Medicine herbsnacupnxr@ Tue, 13 Feb 2007 20:31:18 +0000fee splittingI am so tired of all these people wanting to engage in fee splitting,though it's an illegal practice. I get job offer after job offer withpercentage based payment (and generally an unfair one in myestimation) . does anyone know the penalty if you get caught feesplitting? does anyone know of anyone who has gotten caught? ____________ _________ _________ _________ _________ _________ _Get connected - Use your Hotmail address to sign into now. http://get.live. com/messenger/ overview[Non-text portions of this message have been removed]<!--#y! grp-mlms g {font-size:13px;font-family:arial,helve! tica,clean,sans-serif;}#ygrp-mlmsg table {font-size:inherit;font:100%;}#ygrp-mlmsg select, input, textarea {font:99% arial,helvetica,clean,sans-serif;}#ygrp-mlmsg pre, code {font:115% monospace;}#ygrp-mlmsg * {line-height:1.22em;}#ygrp-text{font-family:Georgia;}#ygrp-text p{margin:0 0 1em 0;}#ygrp-tpmsgs{font-family:Arial;clear:both;}#ygrp-vitnav{padding-top:10px;font\ -family:Verdana;font-size:77%;margin:0;}#ygrp-vitnav a{padding:0 1px;}#ygrp-actbar{clear:both;margin:25px 0;white-space:nowrap;color:#666;text-align:right;}#ygrp-actbar ..left{float:left;white-space:nowrap;}.bld{font-weight:bold;}#ygrp-grft{font-fami\ ly:Verdana;font-size:77%;padding:15px 0;}#ygrp-ft{font-family:verdana;font-size:77%;border-top:1px solid #666;padding:5px 0;}#ygrp-mlmsg #logo{padding-bottom:10px;}#ygrp-vital{background-color:#e0ecee;margin-bottom:20\ px;padding:2px 0 8px 8px;}#ygrp-vital #vithd{font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text-transf\ orm:uppercase;}#ygrp-vital ul{padding:0;margin:2px 0;}#ygrp-vital ul li{list-style-type:none;clear:both;border:1px solid #e0ecee;}#ygrp-vital ul li ..ct{font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;paddin\ g-right:.5em;}#ygrp-vital ul li .cat{font-weight:bold;}#ygrp-vital a {text-decoration:none;}#ygrp-vital a:hover{text-decoration:underline;}#ygrp-sponsor #hd{color:#999;font-size:77%;}#ygrp-sponsor #ov{padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;}#ygrp-sponsor #ov ul{padding:0 0 0 8px;margin:0;}#ygrp-sponsor #ov li{list-style-type:square;! pad ding:6px 0;font-size:77%;}#ygrp-sponso! r #ov li a{text-decoration:none;font-size:130%;}#ygrp-sponsor #nc {background-color:#eee;margin-bottom:20px;padding:0 8px;}#ygrp-sponsor ..ad{padding:8px 0;}#ygrp-sponsor .ad #hd1{font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height\ :122%;}#ygrp-sponsor .ad a{text-decoration:none;}#ygrp-sponsor .ad a:hover{text-decoration:underline;}#ygrp-sponsor .ad p{margin:0;}o {font-size:0;}.MsoNormal {margin:0 0 0 0;}#ygrp-text tt{font-size:120%;}blockquote{margin:0 0 0 4px;}.replbq {margin:4;}-->________ New Mail is the ultimate force in competitive emailing. 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Guest guest Posted February 15, 2007 Report Share Posted February 15, 2007 On 2/15/07, J. Lynn Detamore <lynndetamore wrote: When I practiced in Poulsbo and Seattle, I researched renting at NIAOM. They were charging a % of patient collections. At the time I was sure it was a little fishy. But, it was a SCHOOL doing so. If was really, truly, for certain not legal, would they do it? I guess so! take it from me, the level of literacy at acu colleges on prac. mgmt issues is low. that's why we grad. with little understanding of laws and regs: they don't know them. eg: still trying (for 5 years now) to get a realiable answer on how many years one is required to store patient charts in NC. just today asked the admin. dir. of a local acu college who had no idea, and even less on how to find out. i'm taking a class with an integrative MD next weekend. she *should* know. kb > > -- Kath Bartlett, LAc, MS, BA UCLA Oriental Medicine Experienced, Dedicated, Effective Asheville Center For 70 Woodfin Place, Suite West Wing Two Asheville, NC 28801 828.258.2777 kbartlett www.AcupunctureAsheville.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2007 Report Share Posted February 15, 2007 Kath, for a real answer on healthcare info / records storage, call the NC Healthcare Information Management Association. They're online, of course, at http://www.nchima.org/. For anyone who has HIM - healthcare information management, i.e. storage-retention, subpeona vs court order obligations, etc - go to your state HIMA. They're the experts. They probably have a manual you can buy, also. I was HI Coordinator at Bastyr's cliinic for 6 1/2 yrs, and I made sure we obtained WSHIMA's manual for the dept I worked under. I also wrote a Policy-Procedures Manual for HIM, and it's a good idea to do that for you practice, also. It can be brief, just put your policies in writing. Lynn " " TCM List <Chinese Traditional Medicine > Wednesday, February 14, 2007 9:34:59 PM fee splitting On 2/15/07, J. Lynn Detamore <lynndetamore@ > wrote: When I practiced in Poulsbo and Seattle, I researched renting at NIAOM. They were charging a % of patient collections. At the time I was sure it was a little fishy. But, it was a SCHOOL doing so. If was really, truly, for certain not legal, would they do it? I guess so! take it from me, the level of literacy at acu colleges on prac. mgmt issues is low. that's why we grad. with little understanding of laws and regs: they don't know them. eg: still trying (for 5 years now) to get a realiable answer on how many years one is required to store patient charts in NC. just today asked the admin. dir. of a local acu college who had no idea, and even less on how to find out. i'm taking a class with an integrative MD next weekend. she *should* know. kb > > -- Oriental Medicine Experienced, Dedicated, Effective Asheville Center For 70 Woodfin Place, Suite West Wing Two Asheville, NC 28801 828.258.2777 kbartlett@Acupunctu reAsheville. com www.AcupunctureAshe ville.com <http://www.acupunct ureasheville. com/> -- Oriental Medicine Experienced, Dedicated, Effective Asheville Center For 70 Woodfin Place, Suite West Wing Two Asheville, NC 28801 828.258.2777 kbartlett@Acupunctu reAsheville. com www.AcupunctureAshe ville.com Quote Link to comment Share on other sites More sharing options...
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