Policy Title:Professional Courtesy Discount

Policy Number:PHY 006-00

Policy Title:Professional Courtesy Discount

Issue Date:

Revision Date(s):

Effective Date:

Approved By: ______Date: ______

References:

72 Fed. Reg. 51012 (Sept. 5, 2007)

PURPOSE:

To establish guidelines for extending professional courtesy discountsto physicians on the medical staff at ______(the “Hospital”) and the immediate family members of physicians on the Hospital’s medical staff.

DEFINITIONS:

“Professional courtesy” means the provision of discounted health care items or services to a physician or his or her immediate family members or office staff, other than those who are Federal Health Care Program beneficiaries (e.g., Medicare, Champus, etc.), except those determined to have a financial need.

“Immediate family” means husband or wife; birth or adoptive parent, child, or sibling; stepparent, stepchild, stepbrother, or stepsister; father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law; grandparent or grandchild; and spouse of a grandparent or grandchild.

POLICY:

A professional courtesy discountwill be offered to all physicians on the medical staff of Hospital or a member of thephysician’s immediate family, for services provided on or after the effective date of this policy, provided that:

1. The same professional courtesy discount is offered to all physicians and their immediate family members without regard to the volume or value of referrals or other business generated between the parties;

2. The health care items and services provided are of a type routinely provided by Hospital;

3. The physician or immediate family member is not a Federal Health Care Program beneficiary (e.g., Medicare, Champus, etc.), unless there is a good faith determination of financial need;

4. The professional courtesy discountdoes not violate the anti-kickback statute or any Federal or State law or regulation governing billing or claims submission.

5. Professional courtesy discounts will be offered as follows:

[customizefor your hospital’s discount]:

a)A professional courtesy discount will not exceed $______annually per physician, including physician’s immediate family. This discount will apply to the account balance remaining after insurance benefits are received. Any remaining amount will be the responsibility of the physician.

b)If there is no insurance benefit for the physician or immediate family member, the same professional courtesy discount will exist at $______per physician/family, but the charge will be discounted ____% prior to payment. Any remaining payment amount will be the responsibility of the physician or immediate family member.

This policy was adopted by Hospital’s Board of Trustees and effective on ____, 20__.

______

Chair, Board of Trustees

______

Date

Disclaimer:

The documents in this toolkit are provided for general information and should not be relied upon as legal advice, representation or counsel. All hospitals have unique circumstances and needs, and these samples are intended to be customized by the hospital and the hospital's legal counsel to meet the unique needs of the organization. Legal requirements vary by jurisdiction and change over time, and it is the responsibility of the hospital to comply with the law and any changes to it. QHR assumes no responsibility or liability for the use of these documents by recipients or for changes made to these documents by recipients. QHR makes no guarantee or warranty, including without limitation any warranty of merchantability or fitness for a particular purpose, with respect to this information.