OBCE Update on Fee-Spitting Rule & Online Advertising

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Doctors, all, Since July 2011, the OBCE has communicated (several times) that online coupon sales where the fee is split on a per patient basis between a chiropractic clinic and the advertising company violates the OAR (24) prohibitions against “splitting fees or giving or receiving a commission in the referral of patients for services.” Since then there have been additional developments and questions. Groupon and Living Social now offer flat-fee advertising contracts which do not violate the rule. DCs should make sure they are signing this version of any contract. These contracts may have provisions in which the advertiser holds the revenues in trust until the promotion has concluded and then deducts their flat fee from the total. SprigHealth.com has a web site where patients may schedule an appointment. Sprig Health is in the process of modifying their chiropractic program to come into compliance with the rule. One online advertiser purportedly has charged a “flat fee” which is the coupon sales total. Since under this arrangement the cost to the chiropractic clinic would rise or fall depending on the per patient sales, the OBCE has determined this also violates the rule. The Washington State Chiropractic Quality Assurance Commission is also addressing this issue. They are asking if the coupon fee-splitting programs violate their anti-rebate rule. The OBCE doesn’t have jurisdiction over DCs licensed in Washington State. Question: Is it fee splitting if the doctor’s portion of the split is donated to a non-profit charity? Answer: Yes, as the advertiser still receives a split on a per patient basis. Question: A DC/L.Ac.asks if she can advertise on Groupon as a L.Ac.?Answer: The OBCE would not have jurisdiction as long as chiropractic & “DC” are not referenced in the advertisement. However, caution is advised. Question: A DC has a LMT in office; can that person advertise with a fee-splitting coupon advertiser?Answer: If the LMT is part of the chiropractic clinic, the answer is No. Question: A DC has a LMT in office, can that person advertise with a fee-splitting coupon advertiser, but also say that a free chiropractic exam is part of the offer, but the chiropractor gets no payment?Answer: The answer is No. Dave McTeague, Ex. Dir.,Board of Chiropractic ExaminersOregon.obce@... http://www.oregon.gov/OBCE/index.shtml