Legislators in Massachusetts on several occasions have introduced a bill to limit these types of practices, requiring that any preferred-provider arrangement contain a provision barring the physician from charging an access fee to a covered person.
Dr. Levinson insists that his concierge fee pays for services not covered by the insurance contract, or by Medicare.
It pays for 24-7 access, which includes access at unusual times of the day, “but even if they come to my office for a normal medical visit, I'd bill [their insurer] for medical care provided.” In other words, his fee does not cover medical care.
As for the Massachusetts legislation, “so far it hasn't gone anywhere,” Dr. Levinson said.
At the time of the interview with Dr. Levinson, the Government Accountability Office was planning to issue a report on the impact of retainer medicine on Medicare.
“We are hopeful it will show that retainer care is a very small part of American health care without any significant impact across the board,” he said.
And indeed, the GAO's report, issued in August, concluded: “The small number of concierge physicians at the time of our review, along with information from available measures of access to services, suggests that concierge care does not present a systemic access problem for Medicare beneficiaries at this time.”