Offering Free Services

Offering Free Services

Am I Able to Offer Free Services as A Promotional Tool?

Technically, the answer is a very limited “yes,” but with caution lights flashing. There are a number of risks that have to be weighed against potential benefits.

In the first place, for Medicare or Medicaid patients or any other patients who are covered by a federally funded plan, federal law limits you to a maximum of $15 worth of free services per visit, but never more than a total of $75in value in any given year. Do you really believe the free services you are providing for those patients are worth only $15? And even for non-Medicare/Medicaid patients, when insurance companies learn that you are giving away services you deem to be worth $15, would you want them to start using $15 as your usual and customary fee when determining reimbursement? (For additional information about screenings on Medicare beneficiaries, click here)

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In addition, many doctors offer free “screenings” that almost always result in patients needing additional services that cost money. With this result, you run a risk that patients will complain to authorities that you used “bait and switch” tactics, or that you engaged in other types of unprofessional and unethical conduct. You should make certain that your screenings do not result in a disproportionate number of patients who are determined to need additional costly x-rays and treatment.

A related pitfall occurs when a patient who has received free x-rays requests copies of the x-rays so he or she may make them available to another doctor. Under state and federal law, the physician who has provided any x-rays, free or otherwise, must give copies to the patient and may only charge reasonable costs for reproducing the films – the physician may not decide after the fact to charge the patient for the taking and interpreting of the films. A corollary is that the physician may not hold back copies of the requested x-rays for any fee other than reasonable copying charges.

Another area that requires great caution is the offering of free offsite screenings.  According to the Illinois Department of Financial and Professional Regulation (IDFPR), doctors may not send unlicensed assistants out of the office to perform unsupervised “screenings“ using subjective tests that require professional licensure and interpretation. For detailed information about this IDFPR regulatory advice, click here).

If you still opt to offer free services after weighing all of the risks, make certain you include in every advertisement that the offer is not available to patients covered by Medicare, Medicaid or other federally funded health plans. The Illinois Department of Financial and Professional Regulation has investigated and disciplined a number of doctors for failure to include the disclaimer notice. Also, remember that any and all promotional communication constitutes “advertising.” This means that the disclaimer must be included in every form of communication, including your website, social media accounts, radio, television, pamphlets, business cards, coupons, mailers, signage at health fairs, and any other form of communication.  Your website and social media accounts in particular are easily scrutinized for compliance by regulatory investigators.

About Author

Adrienne Hersh, JD, ICS Legal Counsel

Adrienne has worked as the Illinois Chiropractic Society's General Counsel since 2003. She represents the Society as in-house counsel and advises the organization on a wide range of legal issues affecting chiropractic physicians, including licensing laws and rules, scope of practice, insurance and reimbursement, business structuring, labor and employment, contracts and litigation. Adrienne previously served for 8 years as general counsel to the Illinois Department of Professional Regulation (now the Division of Professional Regulation, Department of Financial and Professional Regulation), where she was chief legal counsel responsible for overseeing all legal issues and advising the 50+ licensing and disciplinary boards, including the Medical Disciplinary Board and the Medical Licensing Board. She is a member of the Illinois State Bar Association Health Care Section, the Illinois Association of Healthcare Attorneys, and the National Association of Chiropractic Attorneys.

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