Medicare Compliance & Reimbursement - 2005 Issue 30
CONCIERGE CARE: Extra Fees For Medicare Patients Don't Pose Problem, GAO Says
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Article Overview
This article summarizes a Government Accountability Office report on concierge care and Medicare. It discusses the federal and HHS perspectives on extra-fee practice models, the concerns raised by the Office of Inspector General, and why the report did not recommend immediate action. The piece is relevant to physicians, compliance staff, and coders who need to understand the broad policy context around services that may be outside Medicare coverage.
Why This Topic Matters
Concierge practice models can create compliance and billing questions for Medicare-participating physicians. This article helps readers understand the general regulatory landscape and the types of services and concerns being discussed.
Article Sections
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GAO review of concierge care and Medicare
Introduces the government report and the broader question of how concierge practice models intersect with Medicare policy and access concerns.
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HHS and OIG commentary
Summarizes federal agency perspectives and the background concerns that led to increased attention on concierge arrangements.
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GAO Doesnt Recommend Action - For Now
Describes the report’s overall posture and the discussion of whether federal action or added guidance may be needed later.
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Billing, coverage, and practice-model considerations
Covers the article’s general discussion of how physicians may think about Medicare participation, billing, and service offerings in concierge settings.
What You Will Learn
- How a GAO report framed concierge care in relation to Medicare
- What federal agencies had said about concierge practice models
- Why some physicians sought more guidance on concierge arrangements
- What broad billing and compliance concerns were being discussed
Who Should Read This
- Physicians
- Medical practice managers
- Compliance professionals
- Medical coders
- Healthcare administrators
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