Jennifer Kirschenbaum, JD

Q: Can physicians profit from in-office product sales (such as vitamins, nasal washes, and skin care products). The American Medical Association (AMA) seems to frown on this activity but I know many physicians who do it. 

No rule exists prohibiting you from selling products in your office-generally. Prohibitions and regulations regarding specific products and devices are on the books, however. Obviously, if a product is not approved by the U.S. Food and Drug Administration, you should not sell it in your office.  

As you point out, the AMA does not support selling products, as stated in Ethics Opinion 8.062 available here: 

									http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8062.page

Answers to our readers questions were provided by Jennifer Kirschenbaum, JD, healthcare department manager for Kirschenbaum & Kirschenbaum PC, Garden City, New York. 

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Thinking of the selling products in your office? Here's what you need to know before taking the plunge.

Review ethics guidelines when selling products

Q: My practice is slow, and I'm wondering whether it's legal to offer one-time free consults to anyone who comes in with a question, regardless of whether the person has insurance? 

It depends. Medicare prohibits physicians from receiving more than $10 as a one-time gift or more than $50 cumulative annually in gifts. If you accept Medicare and your consultation would otherwise be reimbursable, offering free consults may constitute an improper inducement.  

If you do not accept Medicare or your practice is only fee-for-service, you may price your services however you choose, including offering them for free. Because you would likely advertise any such promotion, however, be advised that any time you offer an inducement for patients to use your services, you may be inviting scrutiny of your practice. 

If your business slows, you might consider giving free consults. Find out why this might not be the best idea.

Use caution when offering free consults

Q: Recently I received a new contract from one of the insurance companies my practice works with. Is it worth taking the time to review, or should I just sign it? Are these contracts negotiable? 

Without question, you should review your provider contracts. You may be surprised to learn that often you can negotiate certain elements of the contracts with the insurer. Many doctors do not read their provider contracts, which is a terrible mistake for which you may pay dearly should a contract be terminated without your consent.  

If you rely on patients who are third-party beneficiaries, as most doctors do, you may unknowingly jeopardize your relationship with a payer if you are not aware of the terms of your contract. For example, many payers use contract renewals that require a practice to submit all claims electronically. If you still file paper claims, signing that provider contract would create a situation in which you are automatically breaching its terms.  

When you receive a contract, review it carefully, ask questions, talk to your attorney, and make sure you understand what you are agreeing to, because you will be obligating yourself and your practice to the terms of that document. 

Think you don't need to read your contracts? Think again.

Author | Jennifer Kirschenbaum, JD

Articles

Review ethics guidelines when selling products

Use caution when offering free consults

Reviewing provider contracts is worth the effort