In the last 2 years the Billing Integrity Program has seen an increase in the number of physicians treating and billing for family members or themselves. Physicians whose family billings exceed $1000 are now being reported to the College of Physicians and Surgeons of British Columbia.
Preamble C. 19(1) of the MSC Payment Schedule and the Doctors of BC Guide to Fees states:
Services are not benefits of MSP if a medical practitioner provides them to the following members of the medical practitioner’s family:
a) a spouse,
b) a son or daughter,
c) a step-son or step-daughter,
d) a parent or step-parent,
e) a mother-in-law or father-in-law,
f) a grandparent,
g) a grandchild,
h) a brother or sister, or
i) a spouse of a person referred to in paragraph (b) to (h).
You should also be aware that billing for services to a family member is in contravention of the CMA Code of Ethics, which states: “Limit treatment of yourself or members of your immediate family to minor or emergency services and only when another physician is not readily available; there should be no fee for such treatment.”
Billing for family members raises an ethical flag, which can lead to increased attention from the Billing Integrity Program—something most doctors would like to avoid. Billing a $30 visit for a family member is not worth the risk of being audited.
The CMPA has also written an article in the April CMPA e-bulletin on this subject: “Know the rules, avoid the risks: Treating family and friends.” To view this article, visit http://bit.ly/1jvwgFr.
—Keith White, MD, Chair,
Patterns of Practice Committee
This article is the opinion of the Patterns of Practice Committee and has not been peer reviewed by the BCMJ Editorial Board. For further information contact Juanita Grant, Audit and Billing Advisor, Physician and External Affairs, at 604 638-2829 or email@example.com.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org