Concierge Medicine Florida

Concierge medicine goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. By any name, concierge medicine is the solution for doctors trying to maintain their integrity and independence in today’s difficult healthcare environment.Concierge medicine is a new style of practice with old roots, in which doctors limit their patient base in order to provide patients with personalized service, high quality care, 24-7 availability, and other amenities. In exchange for this enhanced personal attention, patients pay physicians an annual fee. This concierge fee enables physicians to increase their compensation while managing their workload. In addition to receiving an annual fee, most concierge physicians continue to receive reimbursements from health plans and private pay clients.

Concierge medicine is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design.The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all concierge medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged. There are an estimated 5,000 concierge, or membership medicine doctors throughout the U.S. Concierge physicians care for fewer patients than in a conventional practice. All generally claim to be accessible via cell phone or email at any time of day or night or offer some other special service beyond the normal care provided. The annual fees vary widely, from $600 to $5,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services.

Some concierge practices do not accept insurance of any kind. These are as cash-only or direct primary care practices. By refusing to deal with insurance companies, these practices can keep overhead and administrative costs low, thereby providing affordable healthcare to patients. They become concierge only if the practice assesses an annual or monthly fee instead of or in addition to a fee for each medical service. Other concierge practices do take insurance, even Medicare, but ask for an annual fee for additional services exclusive of insurance plans. This annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations, or emergency care from other providers.

HIGH MEDICAID FACILITY

  (F) HIGH MEDICAID FACILITY DESCRIBED.—oAs added
by section 1106(2)(D) of HCERA. A high Medicaid facility
described in this subparagraph is a hospital that—
(i) is not the sole hospital in a county;
(ii) with respect to each of the 3 most recent
years for which data are available, has an annual percent
of total inpatient admissions that represent inpatient
admissions under title XIX that is estimated to
be greater than such percent with respect to such admissions
for any other hospital located in the county
in which the hospital is located; and
(iii) meets the conditions described in subparagraph
(E)(iii).
(G) PROCEDURE ROOMS.—In this subsection, the term
‘procedure rooms’ includes rooms in which catheterizations,
angiographies, angiograms, and endoscopies are performed,
except such term shall not include emergency
rooms or departments (exclusive of rooms in which catheterizations,
angiographies, angiograms, and endoscopies
are performed).
(H) PUBLICATION OF FINAL DECISIONS.—Not later than
60 days after receiving a complete application under this
paragraph, the Secretary shall publish in the Federal Register
the final decision with respect to such application.
(I) LIMITATION ON REVIEW.—There shall be no administrative
or judicial review under section 1869, section
1878, or otherwise of the process under this paragraph (including
the establishment of such process).
(4) COLLECTION OF OWNERSHIP AND INVESTMENT INFORMATION.—
For purposes of subparagraphs (A)(i) and (D)(i) of paragraph
(1), the Secretary shall collect physician ownership and
investment information for each hospital.
(5) PHYSICIAN OWNER OR INVESTOR DEFINED.—For purposes
of this subsection, the term ‘physician owner or investor’
means a physician (or an immediate family member of such
physician) with a direct or an indirect ownership or investment
interest in the hospital.
(6) CLARIFICATION.—Nothing in this subsection shall be
construed as preventing the Secretary from revoking a hospital’s
provider agreement if not in compliance with regulations
implementing section 1866.’’.
(b) ENFORCEMENT.—
(1) ENSURING COMPLIANCE.—The Secretary of Health and
Human Services shall establish policies and procedures to ensure
compliance with the requirements described in subsection
(i)(1) of section 1877 of the Social Security Act, as added by
subsection (a)(3), beginning on the date such requirements first
apply. Such policies and procedures may include unannounced
site reviews of hospitals.
(2) AUDITS.—Beginning not later than May 1, 2012, the
Secretary of Health and Human Services shall conduct audits
to determine if hospitals violate the requirements referred to
in paragraph (1). oAs revised by section 10601(b).