ALERT!! (Posted October 17, 2005)

NOTICE TO THE MEMBERS OF THE NYSRS IN RESPECT TO ARRANGEMENTS PROPOSED BY SCHEDULING SERVICES

In the last year or so, groups of radiologists in New York State have been contacted by one or more diagnostic imaging scheduling services. These entities seek to establish, by contract, networks of radiologists to provide diagnostic imaging for persons who have suffered work-related injuries or illnesses, compensable under the Workers' Compensation law. Some scheduling services also serve persons covered by no-fault auto insurance.

The scheduling services enters into arrangements with insurers and self-insured employers. The radiologists who provide the imaging by subcontract are expected to accept a fee below the established fee schedule. They may be required to allow the scheduling service to file claims for payment under the radiology group's billing number, with the scheduling service collecting payment of the claims. The scheduling service promises payment to the radiologist very promptly, sometimes within 72 hours of rendering the service and without awaiting payment of the claim by the insurer or employer. However, the payment to the radiologist may be subject to repayment in the event the insurer or employer does not ultimately pay the claim.

Since a number of members of the NYSRS have requested advice as to whether the subcontracts between the scheduling service and the radiologists would be "legal" in this state, the counsel to the NYSRS was requested to investigate the matter and to offer any appropriate advice to the NYSRS. The NYSRS received that advice and has decided to make it available to its members. That advice is as follows:

First: A radiologist who enters into a contract of the type described above with a scheduling service that is not organized in this state as a professional medical corporation (or as another entity authorized by state law to practice medicine) will incur a significant risk of committing professional misconduct under the laws and regulations pertaining to the unauthorized practice of medicine by business entities, fee-splitting and referral for a fee. In counsel=s opinion, such arrangements are frought with danger and should be avoided.

Second: The proposed contracts submitted by the properly organized scheduling service may raise numerous other legal and economic issues. Counsel strongly recommends and urges each radiologist considering such a contract to have their own legal counsel review the proposed arrangement thoroughly, to explain the consequences of the contractual terminology and to suggest possible alternatives.

Attorneys retained by members of the NYSRS are welcome to contact the counsel to the NYSRS for additional details in respect to the suggestions set forth above.

Legal counsel to the NYSRS is Pinsky and Pinsky, P.C. (Philip C. Pinsky or Roy D. Pinsky), 315-446-2384.

NYSRS Website Host:
Department of Radiology
School of Medicine
State University of New York at Stony Brook
Health Sciences Center