CHICAGO — Radiology practice marketing: Do it right, and you'll attract new patients, get some love from referring physicians, and grow your practice. Do it wrong, and you could end up facing a hefty fine or even jail time.
Peggy Martin, marketing communications manager for Adventist Health, and W. Kenneth Davis, JD, an attorney at KattenMuchinRosenman LLP, helped the RSNA 2012 attendees figure out how to promote their practices without ending up in the pokey.
What to consider
While there are plenty of legal restrictions on how you market your practice, two areas are especially relevant. The first is anti-kickback laws. That's a federal law that prevents you from offering money or gifts to lure patients into your clinic. This is a felony. Violate it, and you could go to jail.
The second is Stark laws. This prevents you from offering incentives, money or gifts to referring physicians so they funnel patients to you. The good news? It's a civil code, so you won't go to jail if you run afoul of the code; you'll just face a fine. The bad news? You don't need to show intent to be in the wrong. Even if you had no idea you were violating the law, you'll still pay a penalty.
Here are a few scenarios that demonstrate some dos and don’ts for marketing your practice.
Scenario 1: The Facebook scavenger hunt
A radiology practice partners with local restaurants to promote awareness for mammograms. They place breast-health-awareness banners in local restaurants. Users can post a picture of themselves posing with the banners on the practice's Facebook page for a chance to win small prizes.
The Verdict: Probably OK
This is about building brand awareness, not specifically bribing patients to come in to the clinic. Plus, it's about breast health. Since the federal government is making mammograms and breast health a priority, you're probably in the clear.
Scenario 2: Groupon for services
A clinic offers a deal through the service Groupon for sclerotherapy. Patients get the procedure as a steep discount, and Groupon gets a cut of every deal sold.
The Verdict: It's a gray area.
If Medicare or Medicare pays for a procedure, and you offer a discount to Medicare patients, that counts as a kickback. Plus, Groupon getting a cut is a lot like offering a commission for patients. That's a no-no for anything Medicare pays for. If it's not offered to Medicare patients, or it's not something Medicare pays for, you should be OK.
Scenario 3: PET scan pets
To promote a new PET scanner, a clinic offers branded Beanie Babies to the first 50 referring physicians each month.
The Verdict: Don't do it.
If you're offering an incentive to referring physicians only, that violates Stark laws. You won't go to jail, but you could pay a huge fine.
Scenario 4: A clinic invites referring physicians to a barbecue to show their appreciation for their business.
The verdict: Keep track of how much you spend.
Stark laws allow clinics to spend a certain amount a year on non-monetary compensation — you know, things like pens, mugs, tchotchkes, and yes, food. For 2013, the limit will be $380 per referring physician. To stay in the clear, you'll have to do some math. Figure out how much you spent on food and divide it by the number of doctors present, and put that on the spreadsheet you're using to keep track of how much you've spent this year. (You are using a spreadsheet or some other tracking mechanism, right? If not, start immediately.)
Scenario 5: A clinic offers free educational lunches to physicians in the area. They provide subs and chips, and spend the full hour educating clinicians on new technology.
The Verdict: That should be OK.
Educational offerings don't run afoul of Stark laws. If you want to be extremely cautious, you can do the same thing you did for the barbecue: Figure out how much you spent per doc and put that on your spreadsheet.
Scenario 6: A clinic offers free educational dinners to referring physicians at a high-end steakhouse. They spend 15 minutes talking about technology, and two hours binging and boozing.
The Verdict: Nice try, but that's not education.
Stark laws are designed to prevent large gifts that would sway physicians to send patients to you. High-end parties count as large gifts. What's more, in that situation you may have to apply the entire cost of food to each physician present, instead of dividing it up per person. So be careful when schmoozing, sponsoring holiday parties, or providing other ritzy entertainment. It adds up.
Scenario 7: The office manager at a referring physician suggests that a clinic bring a bunch of pizza for lunch just to you can get to know each other.
The Verdict: Not kosher.
If anyone at the referring physicians asks for a gift, a party, a meal, a beanie baby, it doesn't fall into the allowable non-monetary compensation realm. It's forbidden.
Scenario 8: A clinic wants to provide CME for physicians in your area.
The Verdict: OK, but...
If this is CME that the referring physician would have to pay for if you weren't offering it, you need to charge them. If you don't, it goes on that non-monetary compensation spreadsheet. The good news? You're not comparing your course to the fancy ones in Aspen that charge thousands of dollars and involve skiing breaks. You can check out what the cost-conscious CME providers in your area charge, and use that as a basis for comparison.
Scenario 9: You're one of several departments in your hospital that is marketing to referring physicians. You want to send them a nice fruit basket on the holidays.
The Verdict: Watch out
The total amount of non-monetary compensate you can give to referring physicians is calculated by entity, not by department. So if the radiologists, the cardiologists, the hospital CEO, and all the other departments are each sending a fruit basket, you may be violating Stark laws. Check to see who's giving what, and how much it coasts.
Scenario 10: You've got a great ad full of smiling faces proclaiming your clinic the "best in town."
The Verdict: You could be in trouble.
The best? Really? How are you quantifying that? If you can't prove it, you may be violating your state’s truth-in-advertising laws. And those smiling faces, are they models, or patients? Passing off stock-art models as patients is also a truth-in-advertising violation. If they're patients, did you get signed releases allowing you to use their images? If not, that may be a HIPAA violation.
