N.J. Admin. Code § 13:30-8.13

Current through Register Vol. 56, No. 21, November 4, 2024

Section 13:30-8.13 - Permissible business structures, prohibition on referral fees and fee splitting

(a) The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise.

"Associate" means a health care professional who is a partner, an employee, a fellow shareholder in a professional service corporation or a fellow member of another permissible practice format, properly organized pursuant to law.

"Board" means the New Jersey State Board of Dentistry.

"Closely allied health care professional" means an individual who provides professional services and is licensed to practice by a professional or occupational licensing board or other State agency, in any of the following fields: dentistry, medicine (or its branches), nursing, optometry and physical therapy.

"Health care provider" means an individual who or entity which provides health care services, including, but not limited to, closely allied health care professionals.

"Limited liability company" means a limited liability company formed under the laws of this State, pursuant to the New Jersey Limited Liability Company Act, 42:2B-1 et seq., except where inconsistent with these rules.

"Permissible business format" means:

1. Sole proprietorships;

2. All partnerships, including limited liability partner-ships (comprised of dentists or closely allied health care professionals);

3. Professional service corporations (comprised of dentists or closely allied health care professionals); and

4. Limited liability companies (comprised of dentists or closely allied health care professionals).

"Professional service corporation" means a business entity as defined in 14A:17-1 et seq.

"Referral" means the sending or directing of a person to any health care provider (other than an associate) for diagnosis, evaluation, treatment or the furnishing of dental or other health services.

"Remuneration" means any salary, payment, distribution of income, dividend, interest income, loan, bonus, commission, kickback, bribe, rebate, gift, free goods or services of more than nominal value, discount, the furnishing of supplies, facilities or equipment, credit arrangement and waiver of financial obligations.

(b) Dentists may engage in the practice of dentistry in any permissible business format in which they are not shielded from liability for their own breaches of professional duties, they retain responsibility for the quality of care and the appropriateness of their professional judgments, and they are assured access to information and involvement in issues pertaining to quality of care, professional judgment, recordkeeping, advertising practices, and the finances of the permissible business format.

(c) Dentists may be employed by a permissible business format which includes one or more closely allied health care professionals, including at least one licensed dentist, provided their professional practice is not supervised and evaluated by a professional who is not a dentist.

(d) Dentists shall not receive, solicit, offer or pay any remuneration as an inducement to make a referral or as compensation for a referral of a patient for a service, product, drug or device or to purchase, prescribe or recommend a product, drug or device. Nothing contained in this section shall prohibit a licensee from paying the reasonable costs of any advertisement permitted pursuant to 13:30-6.1 and 6.2. Nothing contained in this section shall prohibit a dentist from providing a gift to a patient, or from providing a credit for dental services to a patient, provided the gift or credit does not exceed $ 25.00 in value.

(e) Dentists shall not participate in any arrangement or agreement, with any person other than an associate, whereby any remuneration received by that person in payment for the provision of space, professional services, facilities, equipment, personnel, marketing or management services used by the dentist is to be determined or calculated as a fixed percentage of, or otherwise dependent upon, the income or receipts derived from the practice of dentistry. Nothing in this section, however, shall preclude a dentist from entering into a bona fide profit sharing plan or retaining the services of a collection agency.

(f) Dentists may provide professional services in connection with a permissible dental practice as independent contractors provided the arrangement complies with all State and Federal laws.

N.J. Admin. Code § 13:30-8.13

New Rule, R.1987 d.158, effective 4/6/1987.
See: 18 N.J.R. 2419(a), 19 N.J.R. 552(a).
Recodified from N.J.A.C. 13:30-8.15 by R.1990 d.205, effective 4/2/1990.
See: 22 N.J.R. 149(b), 22 N.J.R. 1145(a).
Repeal and New Rule, R.1999 d.68, effective 3/1/1999.
See: 30 N.J.R. 1898(a), 31 N.J.R. 649(a).
Section was "Referral fees".
Amended by R.2000 d.147, effective 4/3/2000.
See: 32 N.J.R. 215(a), 32 N.J.R. 1221(a).
In (d), added a second sentence; and deleted a former (f).
Amended by R.2005 d.309, effective 9/19/2005.
See: 37 N.J.R. 1149(a), 37 N.J.R. 3709(a).
In (a), rewrote definitions "Associate" and "Limited liability company"; added (f).
Amended by R.2011 d.041, effective 2/7/2011.
See: 42 N.J.R. 2217(a), 43 N.J.R. 310(a).
In (d), inserted the last sentence; and in (e), inserted "professional services,".