Referring hospital patients to private practice

Started by Madden007
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Madden007

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Is it legal and ethical to refer patients seen in the ED or consultation service to my private practice? Opinions and rants welcomed, but facts and references will make my day. Best.
 
Maybe it's a regional or sub-specialty thing but it feels like in Boston's child psych community this is very much encouraged. We get flooded with tons of emails from other faculty members presenting kids that they saw during intake but would benefit from a private provider b/c the academic clinics are inundated w/ months-long waiting lists.

From an economics perspective it makes sense to me. If families w/ resources can afford to skip the wait and see a private psychiatrist, ultimately this frees up slots in academic/community hospitals to see pts w/ less means (ex: medicaid, etc)
 
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With a lot of things legal, the answer will depend on exactly what you are doing. Get an attorney for specifics.

If your field is psychiatry and you do a hospital consult eval that follows up in-network in your practice, you are decreasing healthcare costs (new eval not needed again) and maintaining continuity.

If your field is psychiatry and you own an unrelated optometry practice, I wouldn’t self-refer for the patient’s next new eyeglasses.
 
(based upon my recall of a conversation from 10 years ago)

IIRC, there is some issue about having to document your policies, lest you establish an ongoing treating relationship with someone without insurance, and get accused of abandoning them.

I don't fully remember that story.
 
It's considered self dealing and if you were to bill the patient's Medicaid or Medicare, you'd be violating the Stark Law.