The economy has heated up the marketing activity of many healthcare businesses, including physicians. Marketing devices like Groupon have become commonplace, but raise some significant legal issues. So.one such business requested guidance from the Office of the Inspector General of the Department of Health and Human Services and got a nice response.
The requestor operates a website that includes coupons for healthcare items and services and also advertising on behalf of individuals and businesses in the healthcare industry. The healthcare professionals and business people would post coupons on the website, which would give discounts, including discounts on items and services that are covered by Medicare and other state or federal healthcare programs. The website business would have different levels of membership and would charge flat fees for each level of membership. Additionally, the requestor would sell advertising on the website.
The arrangement had certain limitations, including:
1. The providers would not advertise free services, only discounted services; and
2. The providers would be required to give the same discount to any third party payer or insurance carrier, not just to the patient.
The OIG approved the proposal and noted the following key things:
1. The requestor is not a healthcare provider;
2. Payments from providers and advertisers are a set fee, are consistent with fair market value and don’t depend on customers (patients) using coupons or buying services;
3. Advertising would only be received by customers that elected to receive it; and
4. The business structure is not likely to increase utilization.
In short, the OIG thought the requestor was serving only as a conduit of advertising and was not paying anyone to influence any patient’s choice of a provider or supplier.
How exactly does this play if the disclaimer that chiropractors use is also posted on the running deal placed on Groupon and/or any other online deals website?
Thanks for your question. It depends on the payer. If, for instance, you’re talking about Medicare, then the OIG’s comments are germane. If not, if the payer is commercial insurance for instance, the OIG’s comments are not authoritative. That said, many state regulators may follow the lead of the OIG on the issue.
Jeff, isn’t the website “blessed” by the OIG different than Groupon, LivingSocial, etc., which I believe take a percentage fee from the providers and other vendors posting coupons? I think those sites may be more problematic. What do you think??