U.S. Medical Tourism Facilitators At Risk for Accepting Kickbacks from Healthcare Providers in USA & Abroad

If you are a medical tourism facilitator or referral agency that believes it is acceptable to accept commission payments for your services via fee splitting arrangements from healthcare providers, you may wish to reconsider your position and catch up on your reading and compliance requirements.

You - and any U.S. healthcare provider (along with healthcare providers in other countries) can be reported by a "whistle-blower" to the U.S. government for breaking the law.

The whistle-lower could be a jealous competitor, a former employee, an jealous competing provider envious of the business flow to their rival, a patient, or someone else. All they have to do is file a qui tam lawsuit against any involved party benefiting financially from any aspect of the transaction, in cash or in kind, for the value of the referral stream.

Once filed, the U.S. government (Department of Justice) can decide to intervene in the case, and the whistle-blower stands to receive a portion of any funds recovered. The records become publicly searchable and could destroy your chance to work in healthcare altogether (provider or facilitator/referral agent) if you earn the privilege to be listed on the excluded individuals list. And you cannot simply shut down the company to avoid paying the fines.

Every day, I receive emails from providers outside the USA, Canada, Australia, Germany and the UK who solicit me to engage to do their medical tourism business development for a "success fee" a "marketing fee" or some other description of a fee split paid on a percentage of the providers' fees. That's not allowed, unethical, and is flawed in many different ways.

PAYMENT FOR WORK PERFORMED

Any facilitator, case manager or other qualified care coordinator working as the patient's advocate should be paid by the patient on a fee-for-service basis that reflects the value of the professional services rendered.

Any marketing agent should be paid for the value of the work it performs on behalf of the provider on an hourly or other basis that reflects the contracted services performed for the benefit of the provider. In the USA, that rate is about U.S. $85 per hour, and covers tasks such as buying media advertising, art direction, creating or coordinating work from freelancers for ad graphics, images, posting social media updates and advertisements, event organization, creating press releases, etc. It also covers responsibility for managing provider relationships, ensuring message quality to brand standards, timeliness and value for medical tourism "product" advertising campaigns. The marketing agent should help with managing project and campaign annual budgets, resource allocation and collaborating with creatives and publishers. they should also prepare reports of both qualitative and quantitative research and translate their analysis into consumer/business insights to set and inform continuing and ongoing strategies.

The cost of the paid placements for advertising (television and cable TV placements, radio spots, flyers, billboards, bus placards, pull up banners, magazine advertorials, etc.), is in addition to the $85 per hour average rate. The advertising and marketing agent is usually paid monthly for the itemized invoice of work performed on behalf of the provider. It should have no tie to "success" or "closed sales".

Writing articles, voice-over scripts, video scripts, etc., that may be featured as paid advertorial content is paid to the author or ghostwriter who produces the article, and that fee is in addition to the hourly rate paid to the marketing agent.

According to the authoritative "Writer's Market" the going rate in the USA for this assignment tends to run an average of $1.65 per word or $70 per hour. The average magazine article tends to run about 600-700 words in length plus photos. That means that above and beyond the marketing specialists' fees ($85 per hour) and the advertising placement fee of $1200-$1500 per insertion, the authorship of the article such as the one I just wrote and had published (below) can cost approximately $1155 to have the article written, paid to the author.

Medical tourism isn't going to grow if the marketing and advertising is constrained due to illegal arrangements where either party knows or should have known how to conduct their business legally in both the source market and destination market.

ABOUT THE AUTHOR

Maria Todd PhD, MHA is the Director of Business Development at St George Surgical Center in St George, Utah. She brings 40+ years of practical experience and lessons learned to the role. She helps the facility and its surgeons to grow and succeed with their surgical tourism business and contracted insurer and employer relationships.

As a former surgical nurse, she brings a working knowledge and fluency to standard traditional surgical procedures and specialized advanced surgical innovations such as robotic assisted joint replacement, advanced endoscopic and arthroscopic procedures, minimally invasive procedures, transplants, and no/low opioid pain control options.

As a former hospital and health facility administrator, she brings the experience, expertise and lessons learned about price bundling, accreditation preparation and accreditor selection, operational workflows, marketing, branding, and message targeting.

Contact Maria Todd: [email protected] | +1.800.727.4160