LDA - Louisiana Dental Association

federal Anti-Kickback statute prohibits a dentist or any
provider from offering or actually paying remuneration
to entice a person to refer a patient that may be eligible
for services under a federal healthcare program,
including Medicare or Medicaid. Because of the split of
revenue between the dentist and the advertiser, such
as Groupon, for each patient referred, this arrangement
could pose significant problems. A dentist who vilates
federal law could be charged with a felony and subject
to fines, imprisonment and exclusion from federal
healthcare programs.
One detail to keep in mind is that elective, outof-pocket
services that are not covered by private
insurance or federally-funded insurance may fall
outside of the scope of the Anti-Kickback statute.
Checking with your personal attorney about the
application of this federal law as well as any state
counterpart is a must before signing up to market in
this manner.
Potential Pitfall Three: Most Favored Nation
Clause
Dentists who are participating providers in
insurance plans could also unknowingly agree to
give all the insurer’s members the same deal as the
dentist is giving to participants of Groupon or similar
discount selling sites. Many provider agreements
contain a “most favored nation” clause. The provision
requires a healthcare provider to give the insurance
company the lowest rates the provider offers. If a
provider with a most favored nation clause in its
contract with one insurer advertises a lower rate with
Groupon or another advertiser, the provider could be
made to give the insurance company the lower rate too.
Potential Pitfall Four: State Advertising Rules
Finally, if dentists are not careful, their Groupontype
marketing efforts can also run afoul of state
board advertising regulations. Dentists should keep
in mind that certain requirements and disclaimers
are imposed when a dentist advertises routine
dental services at a specific fee. Failing to follow the
rules could result in the dentist having to provide
additional care reasonably related to the advertised
routine dental service at no additional charge.
If done improperly, advertising could do more
harm than good to a dental practice. Dentists need to
keep in mind that the use of electronic marketing can
attract more than new patients. Unwanted attention
from the state board or federal officials can ensue. So,
before you sign up for advertising that requires you
to pay on a per-patient basis, get your legal counsel
to review your strategy. As always, this article is not
meant to replace legal counsel, but is intended to
bring up questions and concerns to be directed to
your legal counsel before jumping into any sort of
“new” marketing.
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