Dr. A has developed an excellent international reputation in his field of specialization and is seeing increasing numbers of foreign patients who travel to Florida exclusively to see him. Many of these patients have health coverage based in their country of origin, and it is difficult to process and collect payment from these foreign payors. Dr. A has been approached by Mr. B, who has developed a business of facilitating claims processing and collection for international payors, and may be able to get Dr. A designated as a preferred provider with some of the payors. Mr. B proposes a contract wherein Dr. A would pay him 20 percent of each foreign payor claim that Mr. B is able to collect on behalf of Dr. A, plus $100 for each new patient Dr. A is able to see in his office as a preferred provider. May Dr. A legally enter into such an agreement?
| a. | Yes, provided the new patients do not qualify as eligible for alien Medicaid coverage in Texas and no claims are submitted to a federal healthcare program for their care. | |
| b. | No, as the proposed payment relationship violates Federal law. | |
| c. | No, as the proposed payment relationship implicates the Foreign Corrupt Practices Act | |
| d. | Yes, provided the payment amounts are set in advance and do not vary based on value or volume of referrals |
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