How Illegal Fee Splitting May Cost You Your New York Medical License

What does New York Law Say About Medical Feethe doctor would pay them 50 percent of the fees
Splitting?for the tests. In another case, a corporation
Generally, New York law bans fee splitting in theemployed doctors and provided them with office
practice of medicine. This prohibition applies to bothspace and equipment in exchange for a percentage
corporate and individual settings. Specifically, Newof their income. Another example is one of a
York Public Health Law section 4501(1) expresslyphysician who had his license suspended for paying
forbids both businesses and individual practitioners toreferral fees to a women's health center that had
practice medicine for profit in a manner that includesbeen referring to him patients for abortions.
"the referral or recommendation of persons to aAre there any exceptions?
physician, dentist, hospital, health related facility, orYes. The law permits physicians to practice medicine
dispensary for any form of medical or dental care orand share fees through partnerships, professional
treatment of any ailment or physical condition." Thecorporations, university faculty practice plans,
law also prohibits physicians and other health carehospitals, HMOs, and employee/student health
professionals and facilities "to accept for medical orprograms. While permitted, such arrangements are
dental care or treatment any person referred orsubject to limitations. For example, a physician who is
recommended for such care or treatment by anot a member of a partnership may not share fees
medical or dental referral service business located inwith the partnership.
or doing business in another state if the medical orWhat about paying salaries to employees?
dental referral service business would bePaying salaries to employees is not illegal fee sharing
prohibited… if the business were located in or doingunless the salaries are contingent on the physician's
business in New York." In simple words, it isincome and are a certain percentage of the income.
prohibited to give or accept fees for patient referrals.Fee sharing with another physician is permitted under
Does the law make any distinction between individualcertain circumstances, such as in the case with a
and corporate practice of medicine when it comes toconsultant or professional subcontractor.
sharing fees?Is it a problem for a physician to employ a billing
In New York, businesses and non-profitscompany or a collection agency?
organizations are not allowed to practice medicine perThat depends on the type of the agreement
se unless they are so certified by the Public Healthbetween the physician and the billing company. By
Council. Therefore, any New York physician whodefault, many billing businesses prefer a
shares or allows others to share in the fees forcontingency-based model where they charge the
medical services with a business entity will bedoctor a percentage of the doctor's income. While
disciplined under NY Education Law section 6530(19).permissible for the billing companies, such practice is a
Illegal fee-sharing involving business entities may takesure way to professional discipline for the physician.
many forms. For example, in a recent case, the courtThe right way would be to arrange for a fixed rate
held that payment of a portion of physicians' incomerepresenting fair market value of the services.
from their private clinic practice to a university as aHowever, this is different with the collections
condition of the physicians' employment with theagencies. Paying collections agencies on a contingency
university was an illegal fee-splitting arrangementbasis depending on the amount recovered is not illegal
where the physicians were not employees of thefee-splitting.
university faculty practice corporation, and theWhat are the legal consequences of violating the
university was not providing the physicians withfee-splitting laws and corporate practice of medicine?
salary, employee benefits, facilities, supplies, staff, orIn the latter case, since businesses are not allowed
malpractice insurance. (Odrich v Trs. of Columbiato practice medicine, such practice is considered
Univ.) Illegal fee-splitting does not always involve"unlicensed practice of medicine", which is a class E
money payments. Giving or receiving any valuablefelony. If convicted, the defendant may serve
benefit such as credit, omission, discount, gratuity,between one to four years in prison and incur
etc. may qualify as fee sharing.monetary penalties. The entity itself will be dissolved.
So what is corporate practice of medicine or illegalPhysicians who enter into contracts with unlicensed
fee splitting?business entities may be charged with fraudulent
By way of example, several court casespractice of medicine or practicing beyond authorized
demonstrate corporate practice of medicine and illegalscope and be subjected to professional discipline.
fee splitting. In one case, a doctor entered into anIllegal fee-splitting is a professional misconduct and
agreement with his technicians that provided that theany physician found to have violated the fee sharing
technicians would perform EEG and ECHO tests andrules will be disciplined.