Thinking concierge? Know these legal risks first

Concierge medicine offers physicians an alternative practice model with enhanced patient relationships and smaller, more manageable panel sizes, but launching such a practice requires careful legal planning.

There are critical compliance requirements for notifying existing patients about the transition, ensuring proper informed consent and structuring membership agreements that clearly outline services and fees. For practices operating under a hybrid model — where concierge fees coexist with traditional insurance billing — understanding the distinction between covered and noncovered services is essential to avoid regulatory pitfalls.

Physicians also need to be aware of the unique legal risks associated with concierge medicine, including potential Anti-Kickback Statute concerns, compliance with state consumer protection laws and proper structuring of retainer fees. Whether you're considering a full concierge model or a hybrid approach, it’s critical to carefully navigate the legal landscape and establish a compliant, sustainable concierge medicine practice.

Medical Economics spoke with Ericka Adler, practice group manager of health care for Roetzel & Andress, about these challenges.