Doctors on Retainer in Maryland: Is This Insurance?

My insurance law class begins with a case called GAF Corp. v. County School Board, a Virginia case that addresses the question of what constitutes insurance. This is not exactly an issue that gets a lot of media attention, being mostly discussed, outside of this case, by geeky insurance law types.

The Maryland Daily Record has an article today about the Maryland Insurance Commissioner’s questions of whether some types of retainer agreements between doctors and patients should be regulated because they constitute insurance.

Doctors on retainer – also called concierge or boutique medicine – is the latest rage for Maryland doctors who are looking to increase profits by charging a retainer to those who can afford it. In return the clients receive perks, such as house calls, no waiting for appointments, and other personalized attention you would expect to get in Mayberry, as opposed to 2009.
Because it sounds a little like medical insurance, paying a “premium” for an uncertain possibility, this model has begun to attract regulatory scrutiny in Maryland. From the article, it sounds like Maryland is taking a wise approach: we won’t call it insurance but doctors need to make sure you are operating within reasonable limits if you want to avoid regulation.