The multidiscipline practice is an idea and reality whose time has come. It is now time for health care practitioners of all disciplines to make their health care services more accessible to patients in a one-stop health care practice. It is a great concept -- the patient can go to one health care clinic consisting of different health care disciplines, and their health care needs will be addressed by the most appropriate health care team physician. However, care and good judgement must be used in implementing the structure and operation of a multidiscipline practice.
A number of organizations advertise extensively throughout the United States on creating multidiscipline practices which consist of doctors of chiropractic and medical doctors. The concepts and role models as advertised seem very attractive to health care providers who are entrepreneurs and have the patients' interest in mind when exploring the multidiscipline potential further. However, it is unfortunate that a number of these multidiscipline practice experts have set in motion a number of practices that are now the subject of fraud investigations. The consultants' actions have caused intense scrutiny of all multidiscipline practices involving MDs and DCs. Investigators must determine what methodology is being used in these practices which may be operating illegally.
The doctor who is ready to join a multidiscipline practice consulting group must know the consultants and that the consultants are knowledgeable in the correct and legal way to build an integrated clinic. A quick way to determine the practice consultant's knowledge is to ask yourself about the philosophy and focus of the advertisement. If you find that it states you would be taught how to avoid or eliminate limited chiropractic coverage, you could be headed for trouble and the target of a fraud investigation. Red flags should pop up if your multidiscipline practice expert tells you how to recruit an MD into your practice as a part-time exam doctor or how to use the MD's name on bills as a means to get higher reimbursement or broader coverage.
The multidiscipline practice should be created for the benefit of the patient and not solely for the purpose of getting paid for your chiropractic services in the name of your part-time exam doctor. Doing so would make you guilty of health care fraud, which can be defined as an intentional act to deceive or misrepresent services (illegally) to gain something of value from another. If you implement your multidiscipline practice for this reason, then you have purposely and intentionally misrepresented to the service provider and your part-time MD can provide the necessary evidence to criminally pursue the entrepreneur for billing services not provided, providing unnecessary or substandard health care services and/or misrepresenting the nature of services provided.
Multidiscipline practices are not illegal -- only the entrepreneur can make them illegal by the way they are implemented. If you have questions on the validity of your multidiscipline practice, you should immediately contact a fraud assessment expert or your attorney for advice.
Daniel J. Osborne, MS, DABFE
Ashville, Ohio
