Doctors charging patients and additional $5 copay to cover the cost of their malpractice insurance.

[Guest DK Ellerson]

Is this legal? If it is, where might I find some official documentation that addresses this. Also if it is, could a Flex participant be reimbursed from their Health FSA for this expense?

Thanks so much for your help.

[MGB]

It doesn't smell right to me. I assume this would be covered under the contractual arrangements between the doctor and the plan of insurance.

[papogi]

I have heard of one provider doing this in the Chicago area, and I'm sure it's something that is growing. As far as the FSA, my thinking would be yes. It is a necessary charge in order to receive medical care from the provider.

[Guest Broot]

I haven't heard of increased co-pays just to pay the malpractice premium, but I am aware of several physician groups who charge a 'retainer' fee (as much as $300 or more per year) in order to be treated by the group.

EBIA had a question regarding FSA reimbursement of the retainer fee last June - their opinion was that it's not reimbursable. Here's the link: http://www.ebia.com/weekly/questions/2003/Caf030626.jsp

[mbozek]

The amount of the co pay is governed by the providers contract with the HMO or health provider. The provider cannot add an additional charge to the co pay any more than a merchant can add additional charges for a credit card payment. I have had several disputes with providers who tried to force patients to pay additional amounts above the co pay to make them whole. If the provider accepts payment from the HMO then the provider can only charge the deductible specificed in the HMO agreement.