Fee Splitting Prohibition Handbook
In Florida, a physician can lose his or her license for splitting fees generated from patient care. The law, which came into effect in 1992, sets forth a list of actions or omissions for which the Florida Board of Medicine (the â€œBoard) may take disciplinary action against a physicianâ€™s license. Section 1(i) prohibits â€œpaying or receiving any commission, bonus, kickback, or rebate, or engaging in any fee-splitting arrangement in any form whatsoever with a physician, organization, agency, or person, either directly or indirectly, for patients referred to providers of health care goods or servicesâ€¦.â€ The statute aims to prohibit doctors and other health care professionals from paying for patient referrals.
The Boardâ€™s interpretation of this statute is important because under Florida regulations, physicians can lose their licenses for violating it. Further, compliance with the statute is an ongoing effort considering the many physician/vendor and physician/physician relationships in todayâ€™s marketplace.
Fee-splitting is not specifically defined by Florida Statute. The Florida Board of Medicine relies on the definition supplied by Websterâ€™s dictionary, which was used in a Florida appellate court decision. Fee-splitting is defined as â€œthe dividing of a professional fee for a specialistâ€™s medical services with the recommending physician.â€ (Practice Management Associates v. Orman, 614 So. 2d 1135 (1993)).
The sanctions for violating the statute are strict, ranging from the refund of fees paid by or on behalf of the patient to medical license suspension or revocation, and a fine between $1,000 and $10,000. Punishment for the second offense ranges from a refund of any fees paid by or on behalf of the patient, and from a 2 year suspension to a revocation or denial and an administrative fine from $5,000 to $10,000.
Ann Bittinger assembled and prepared and handbook on the Florida Fee Splitting Prohibition, available for purchase. The Handbook contains what are purported to be all of the Florida Board of Medicineâ€™s declaratory statements interpreting and applying the statute, which are not easily available. (The Florida Administrative Law Report houses most of them, but FALR is difficult to search without a case name or citation, and only statements rendered since 1993 are available online.) To get access to all of the declaratory statements and decisions involving the Fee-Splitting Prohibition, Bittinger placed a Freedom of Information Act request to the Department of Health and Board of Medicine to obtain all the decisions of the Board concerning the Fee-Splitting Prohibition.
To purchase the handbook, which includes the statute, 32 cases or declaratory statements, which are organized by subject matter and summarized in a separate 28-page analysis section, call our office at 904 821 9000 and ask for the management assistant. The cost is $399.