American Academy of Emergency Medicine

Fee Splitting/Kickbacks

Fee-splitting is a common practice in Emergency Medicine in which the contract management company takes a portion of the physician-generated fees for management expenses and overhead. In some cases, the percentage of fees taken can be excessive and far beyond the fair market value for the services rendered by the contract management company. In other cases, the fees taken can be considered a kickback because the contract management company is essentially referring the patient to the emergency physician.

Leaders in medicine such as the American Medical Association and Dr. Arnold Relman, editor emeritus of The New England Journal of Medicine, have taken strong ethical stands against fee-splitting.

There are also a number of very specific regulations and ruling which control when and in what circumstances fee-splitting is and is not appropriate.

AAEM encourages is members to make themselves aware of this issue on the impact it has on the care of their patients and their professional welfare. Violations of fee-splitting regulations can be reported and acted upon in the following ways.

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