MARYLAND INSURANCE ADMIN. REPORT: [2009] Report on “Retainer” or “Boutique” or “Concierge” Medical Practices and the Business of Insurance

By Maryland Insurance Administration

In late 2008, the Maryland Insurance Administration (“MIA”) r eceived information about so- called “boutique”, “concierge” or “retainer” medical practices (hereinafter “retainer practice”) in which the patient pays an annual fee to a physicia n for certain services. To ascertain if these arrangements constitute the business of insura nce, the MIA held an informational hearing on December 19, 2008. The MIA requested individual s and organizations provide information on retainer medicine in the State of Maryland as noted in Attachment 1. This report summarizes the information provide d to the MIA at its hearing regarding the economic reasons for establishing a retainer pract ice, the potential impact of the growth of retainer practices on physician s upply, and the types of retainer practices. It also provides information on the business of insurance and a framework for ascertaining when a retainer practice is engaged in th e business of insurance. It is important to note what this report does not cover. Much of th e literature on retainer practices focuses on balance billing and medical ethics. 1 These issues were not addressed at the hearing, and the MIA did not explore these issues.



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