Insofar as the retainer fee under such an agreement is truly for noncovered services, such fees would not appear to be in violation of Medicare law, Mr. Thompson continued.
An alert issued by HHS' Office of Inspector General in 2002 reminded physicians that they could “have a problem” if they proposed services to patients in exchange for a flat fee that would otherwise be covered by Medicare. The OIG's chief counsel later clarified that the alert did not specifically take a position on concierge medicine but only addressed fees for covered services and was consistent with the position previously taken by Secretary Thompson.
“At least now we know that the Thompson letter is being enforced—that there are such things as noncovered services, and if we charge for those, that should be okay,” Mr. Marquis said.
Several bills have been introduced in Congress that would prohibit physicians from charging a membership fee to a Medicare beneficiary or would forbid physicians from requiring a Medicare beneficiary to purchase a noncovered item or service as a prerequisite for receiving a covered item or service. These bills “never got out of committee,” Mr. Marquis said.