How Concierge Healthcare Attorneys, LLC Helps Physicians Build Premium, Compliant Practices
Concierge medicine, sometimes called retainer medicine, involves charging patients a subscription or access fee for medical and related healthcare services. It appears that concierge medicine is here to stay, as the concierge medicine market size was valued at over $7 billion in 2024. It is no wonder, then, that many medical practitioners want to enter the concierge medicine space. However, many legal, regulatory, and practical issues need to be addressed to ensure compliance and to promote clarity in the physician–patient relationship. Here is a preview of some of these issues, along with a discussion of how concierge medicine lawyers can help navigate them.
What Is a Concierge Medical Practice?
Concierge medicine is a healthcare model where patients pay a monthly or annual fee. Once available only to the ultra-wealthy, concierge medicine has become increasingly common in recent years. It is also popular for patients, as patients receive more thorough care as well as easier access to their doctors through concierge.
By limiting the number of patients they serve, physicians can dedicate more time to each individual’s care. Concierge medicine also helps reduce administrative burdens, allowing physicians to focus on preventive care and wellness.
Concierge medicine operates under different business structures. The hybrid model involves physicians treating both concierge and non-concierge patients, while the direct primary care model opts out of federal payors to serve exclusively a defined group of member patients.
As traditional primary care becomes increasingly unsustainable, many physicians are embracing concierge medicine—a model that supports smaller panels, deeper relationships, and greater clinical freedom. But making the shift isn’t just operational—it’s legal. Structuring a concierge practice without proper legal guidance can expose physicians to regulatory, contractual, and compliance risks.
Concierge Healthcare Attorneys, LLC is a national boutique law firm focused exclusively on healthcare law. We help physicians transition into concierge and direct primary care (DPC) models with a turnkey, legally sound approach—offered at flat-fee pricing to ensure transparency and affordability.
Why Physicians Choose Concierge Medicine
Concierge medicine replaces the volume-based, insurance-driven model with one that prioritizes patient care and physician autonomy. Under this structure, patients pay a membership fee in exchange for:
- Same-day or next-day appointments
- Extended visits and personalized wellness planning
- Direct access via phone, text, or telehealth
- Focused, unhurried care
Physicians benefit from manageable panels, fewer administrative burdens, and a financially predictable model that aligns with their professional goals.
Legal Services for Physicians Converting to Concierge Care
Concierge Healthcare Attorneys, LLC provides comprehensive, concierge-style legal support to help you build your concierge practice—compliant, secure, and custom to your state and specialty.
1. Entity Structuring and MSO Planning
We assess your existing business structure (e.g., PLLC, S Corp, PC) and determine whether updates or restructuring are necessary. Where appropriate, we also create Management Services Organization (MSO) arrangements for billing, marketing, or multi-provider practices, and draft compliant service agreements.
2. Medicare Opt-Out and Payer Exit Strategy
Many concierge physicians choose to opt out of Medicare and exit commercial payer networks. Concierge Healthcare Attorneys, LLC:
- Prepares and files Medicare opt-out affidavits and private contracts
- Reviews or terminates payer agreements
- Advises on hybrid models where applicable
- Ensures compliance with CMS and anti-fraud rules
All of this is provided as part of our flat-fee transition package, so there are no surprises as you unwind from insurance.
3. Custom Concierge Membership Agreements
Your membership agreement must be crystal clear and legally sound. We draft contracts that:
- Define covered and excluded services
- Outline payment and cancellation terms
- Include HIPAA and telehealth consents
- Comply with state laws and consumer protection statutes
Each agreement is tailored to your practice model and jurisdiction—with flat-fee pricing to help you budget with confidence.
4. State Regulatory and Insurance Law Compliance
We provide detailed memos that address:
- State-specific concierge or DPC laws
- Insurance and prepayment plan restrictions
- Licensing board rules on retainer-based care
- Anti-kickback, CPOM, and related statutes
Concierge Healthcare Attorneys, LLC monitors regulatory developments in all 50 states and ensures your model stays ahead of compliance risks.
5. HIPAA, Telemedicine, and Digital Tools
Modern concierge practices are tech-forward. We review and prepare:
- Telehealth consent forms
- Communication policies for text, email, and app-based messaging
- HIPAA-compliant Notices of Privacy Practices (NPPs)
- Advice on multistate telehealth practice and prescribing
We also assist with vendor contracts and platform risk assessments.
6. Patient Transition Management
If you are converting an existing practice, we draft all the necessary patient communications:
- Termination letters with proper notice and referral options
- FAQs and onboarding packets for concierge patients
- Website disclaimers and launch announcements
Concierge Healthcare Attorneys, LLC ensures continuity of care and protects you from claims of abandonment or coercion.
Membership/Subscription Model Issues and Challenges
The concierge care model, which requires patients to pay a membership fee before being accepted or receiving care, presents challenges, particularly to those new to concierge medicine. Here are some of the most prevalent issues:
- Being Clear About the Scope of Services
- Services included in the membership fee should be clearly defined and specified. Patients must understand exactly what their membership fee covers, including whether it includes annual physicals, same-day appointments, wellness counseling, diagnostic testing, or other services, as well as what remains billable separately or must be covered by insurance.
- Financial and Operational Decisions
- Subscription fees must be set at a level that supports the practice’s operations while providing value to patients. Practices must carefully project patient volume, overhead costs, and staffing needs.
- Insurance Implications
- An important legal consideration is whether an access fee charged by a concierge or prepaid medical practice could be deemed the business of insurance, thereby subjecting the practice or entity to state insurance regulation. While traditional fee-for-service models are generally not classified as insurance, prepaid access fees raise distinct regulatory concerns due to their structure as advance payments for a defined set of future services. In addition, the arrangement must comply with any contractual obligations the provider or entity has with private insurers or third-party payers. Many insurance contracts prohibit balance billing for covered services, and a key legal issue is whether the access or retainer fee includes services typically covered by insurance, such as physical exams, routine office visits, or diagnostic tests, potentially triggering further regulatory scrutiny.
- Terminating the Relationship
- Though concierge medicine is a subscription-based service, it is different from streaming platforms or food delivery services when it comes to ending the relationship with the patient. Both state statutes and professional ethical standards unequivocally prohibit patient abandonment, which is defined as the unilateral termination of a physician-patient relationship without providing the patient with adequate notice and a reasonable opportunity to obtain alternative medical care.
How Concierge Medical Attorneys Help Medical Professionals
Launching a concierge medicine practice brings unique legal and ethical challenges. From structuring patient agreements to navigating complex healthcare regulations, every aspect of a concierge model must be carefully planned to ensure compliance with federal and state laws. Here are some issues that skilled concierge medical attorneys can help medical professionals interested in concierge medicine work through:
Anti-Kickback and Fee-Splitting Concerns
Offering “free” services or bundled clinical and non-clinical offerings may raise red flags under the federal Anti-Kickback Statute and similar state laws, particularly when Medicare is involved. Such services can be seen by enforcement authorities as improper inducements for clinical care, potentially triggering penalties.
Contracts and Patient Agreements
Concierge practices must have clear, written agreements that define fees and the specific services provided. These contracts help avoid violations of state and federal laws, including insurance regulations, medical board rules, advertising standards, and CMS participation requirements. A failure to clearly outline terms can expose the practice to legal and regulatory risk.
Ethical Considerations
Ethical issues arise when patients do not fully understand the value, scope, or limits of the services they are paying for. Practices must ensure that offerings are transparent to support informed patient decisions and avoid accusations of misrepresentation.
Marketing Compliance
Advertising for concierge services must comply with state and federal rules governing physician marketing. All promotional materials should avoid misleading claims about access, quality, or outcomes to stay within legal limits.
Several Other Issues
Concierge medical practices, along with non-physician health and wellness entities, must navigate a complex set of federal and state legal requirements to operate lawfully and effectively. Some include:
- Corporate practice of medicine (CPOM): Non-licensed individuals or entities cannot control clinical decisions, as violations may lead to penalties.
- Privacy and advertising laws: Practices must comply with HIPAA and truth-in-advertising rules to avoid misleading claims about care quality or access.
- Internal referrals: Prepaid packages that allow patients to see any provider in a practice could be viewed as unlawful inducements if owners profit from internal referrals.
Concierge Legal Services — Without Surprise Billing
We understand physicians value transparency, efficiency, and clarity—especially during a major transition. That’s why Concierge Healthcare Attorneys, LLC offers flat-fee billing for concierge medicine legal packages.
Whether you need a full concierge launch plan, a Medicare opt-out only, or a review of existing contracts, we provide:
- Fixed pricing
- Rapid turnaround
- Concierge-level responsiveness
- National scope
Contact Our Experienced Concierge Medical Attorneys Today
Establishing a concierge medicine program requires careful legal planning and expertise. Because this model involves complex issues such as corporate practice of medicine, fee-splitting, and anti-kickback regulations, insurance law, and various state and federal compliance requirements, it is essential to work with concierge medicine lawyers who understand the healthcare regulatory landscape. Having the right legal advice helps ensure the practice follows all applicable rules, reducing the risk of fines or legal issues and allowing focus on delivering excellent personalized care.
Concierge medicine allows you to reclaim your time, build deeper patient relationships, and practice on your terms. But it must be done with a solid legal foundation. Concierge Healthcare Attorneys, LLC is the trusted legal partner for physicians nationwide making the transition to concierge, direct care, or hybrid models. Our experienced attorneys guide you from idea to implementation—efficiently, ethically, and affordably. Contact us today to get started.