The Legal Risks of “Concierge Medicine” in Florida
Concierge medicine is reshaping how physicians deliver care and how patients experience healthcare. Offering personalized attention, streamlined services, and direct access, this model is attractive to both doctors and patients. But in Florida, launching a concierge practice requires far more than a business idea—it demands an understanding of complex legal and regulatory obligations that, if ignored, can endanger a doctor’s license, finances, and reputation.
This guide explores the legal landscape of concierge medicine in Florida, helping physicians identify the risks, understand the rules, and develop a legally compliant care model.
What Is Concierge Medicine?
Concierge medicine, also referred to as retainer-based care, is a healthcare model where patients pay a fee—monthly, quarterly, or annually—for enhanced access to their physician. This may include same-day appointments, direct communication via phone or email, and longer visit times.
Key Features of Concierge Care
Common benefits marketed in concierge models include personalized wellness plans, 24/7 access, preventive screenings, and extended time with the doctor. Some practices may still bill insurance for covered services, while others operate completely outside traditional payers.
How Concierge Medicine Differs from Direct Primary Care (DPC)
Though they may seem similar, concierge medicine and DPC are not the same legally—especially in Florida.
What Is Direct Primary Care?
DPC is a non-insurance model where patients pay a flat fee for unlimited access to routine services. In Florida, DPC is legally defined and enjoys more regulatory clarity under Section 624.27 of the Florida Statutes, which exempts DPC from insurance regulation.
Legal Gray Area of Concierge Care
Concierge care, on the other hand, often mixes retainer fees with traditional insurance billing. This hybrid approach does not enjoy the same statutory protections as DPC and invites greater legal scrutiny from regulators and licensing boards.
Is Concierge Medicine Legal in Florida?
Yes, concierge medicine is legal in Florida. However, legality is conditional, meaning physicians must comply with strict regulations covering:
- Medical licensure
- Contract structure
- Patient billing practices
- Marketing and advertising claims
- HIPAA compliance
Failing to align with Florida’s laws can result in disciplinary action by the Florida Medical Board or lawsuits from dissatisfied patients.
What Florida Law Says About Retainer Fees
Physicians may charge retainer or membership fees for services not covered by insurance. However, those fees cannot be disguised co-pays or insurance substitutes. The contract must clearly explain what the fee includes and whether insurance is still being used.
Annual and Monthly Fee Models
Florida does not prohibit annual or monthly fees, but they must be for non-covered services. Examples may include extended physicals, after-hours access, or health coaching. Any confusion between these fees and traditional billing structures can lead to allegations of fraud or deceptive business practices.
What the Florida Medical Board Requires
The Florida Board of Medicine enforces rules that concierge doctors must follow:
- Ensure all advertising is truthful and not misleading
- Offer medically necessary care without discrimination
- Maintain valid and current medical licensure
- Stay within the scope of permitted services under Florida law
Noncompliance with these expectations—even unintentionally—can lead to investigations, fines, or license suspension.
Risks and Legal Pitfalls of Concierge Practices in Florida
Despite its benefits, concierge care presents numerous legal risks when not implemented correctly. Some of the most common pitfalls include:
1. Vague or Misleading Contracts
Many legal problems stem from poorly worded contracts that lack clarity on fees, services, and patient obligations. If a patient believes they were misled—or if an agreement is inconsistent with state law—it may be challenged in court or trigger board review.
2. Overpromising Access or Outcomes
Guaranteeing “immediate access” or “unlimited visits” may seem like good marketing, but if those services are not actually available, it could constitute false advertising or breach of contract.
3. Combining Retainer Fees with Insurance Billing
Charging a fee while also billing third-party insurers (including Medicare) creates serious legal risks. This may violate federal anti-kickback statutes, Stark Law, or Florida’s insurance regulations.
4. HIPAA and Record-Keeping Violations
Even though concierge practices may seem “off-grid,” they are fully subject to HIPAA, Florida recordkeeping statutes, and patient privacy laws. Failing to secure patient data or properly document visits can be a costly mistake.
Building Legally Compliant Physician Retainer Agreements
The patient contract is the single most important document in your concierge model. It defines the business relationship and sets the boundaries for what services are offered.
Essential Elements in a Florida-Friendly Contract
A legally sound contract should include:
- A detailed list of services covered by the fee
- A disclosure of what is not included (e.g., labs, procedures)
- Billing policies, including how insurance is or isn’t used
- Cancellation and refund terms
- Clear language with no misleading guarantees
Red Flags to Avoid
Avoid ambiguous phrases such as “unlimited visits” or “guaranteed 24/7 access.” Never suggest that retainer fees replace insurance billing, and always clarify that emergency care or hospitalization are outside the scope of the membership.
Do Florida Concierge Doctors Need a Special License?
There is no “concierge medicine license” in Florida. Physicians must simply maintain an active and unrestricted medical license with the Florida Board of Medicine.
Licensure Isn’t Optional—Even in Private Models
All standard requirements apply, including continuing medical education (CME), professional liability coverage, and adherence to the Medical Practice Act. Just because your model is different doesn’t mean the law treats it differently.
Marketing and Patient Communication Risks
Marketing a concierge practice carries its own set of risks. Inaccurate or exaggerated claims in advertising may result in complaints to the Board, particularly if services are portrayed as more accessible or superior without appropriate disclosures.
Truthful Advertising Is Legally Required
Avoid terms like “guaranteed care,” “VIP treatment,” or “instant appointments” unless those claims are demonstrably true. All marketing must accurately represent what your practice offers and how the fees work.
How to Stay Compliant: Best Practices for Concierge Clinics
To minimize risk, Florida concierge doctors should adopt a compliance-driven mindset from day one. The following practices help ensure that your business model stays within legal limits:
1. Conduct a Legal Review Before Launch
Work with a healthcare attorney to vet your contract, service structure, and marketing materials. Many problems can be prevented through early legal review.
2. Maintain Clear Patient Communication
Give patients written explanations of what they are paying for. Verbally walk them through the agreement and encourage questions. Transparency is your best legal defense.
3. Separate Billing Systems
Keep insurance billing systems distinct from concierge services. Never blend the two without legal approval. If billing both, ensure services are clearly segmented.
4. Keep Detailed Records
Document all patient interactions, contract signings, payments, and communications. These records are essential if your practice is ever audited or sued.
5. Train Your Staff
Staff should be trained on how to explain the model, enforce policies, and avoid making promises about access or outcomes that the practice cannot guarantee.
Frequently Asked Questions About Concierge Medicine in Florida
Is concierge medicine actually legal in Florida, or is it in a legal gray area?
Yes, concierge medicine is legal in Florida, but it is not explicitly defined in Florida statutes the way Direct Primary Care (DPC) is. This means that while it is not prohibited, it exists in a more complex legal landscape and must comply with all applicable healthcare laws, licensure regulations, and contractual standards. The legality of concierge medicine in Florida depends entirely on how the practice is structured and how the physician communicates services, fees, and billing arrangements to patients. As long as those components align with Florida’s medical practice laws and avoid misrepresenting services or creating conflicts with insurance billing, concierge care can be legally operated in the state.
Can I charge a membership or retainer fee and still bill insurance?
This is one of the most sensitive legal areas for concierge medicine in Florida. Physicians may charge a membership or retainer fee, but only for services that are not covered by insurance. The fee must not be a disguised co-payment or premium, and it must not overlap with services that are billed to Medicare or private insurers. If there is any ambiguity or overlap between the concierge fee and insurance-covered services, the physician could be accused of double billing or violating anti-kickback laws. To stay on the safe side, doctors should clearly separate services and maintain transparent documentation explaining how and why each fee is charged.
Do I need a special license to operate a concierge practice in Florida?
No, Florida does not require a separate or specialized medical license for concierge medicine. Physicians must hold a standard and valid license issued by the Florida Board of Medicine and remain in good standing. However, this does not mean that concierge models are exempt from state oversight. Any deviation from accepted standards of care, or failure to follow licensing requirements and CME obligations, can result in penalties or board review, regardless of the business model. It’s essential to remain compliant with the same legal expectations applied to all practicing physicians in the state.
What could get me into legal trouble if I start a concierge practice?
There are several common missteps that could lead to legal problems for Florida concierge physicians. One of the biggest is failing to draft a legally compliant patient agreement. If the contract is vague about services, fees, cancellation policies, or insurance relationships, it could trigger patient complaints or lawsuits. Overpromising access, such as guaranteeing 24/7 communication or unlimited visits, without the infrastructure to deliver on those promises, can also result in a breach of contract or false advertising claims. Billing insurance for services that are already paid for through a membership fee, or failing to properly document patient interactions, are also common violations that can prompt investigation by regulators or disciplinary action by the Florida Medical Board.
Can I market my concierge practice as providing “priority care” or “unlimited access”?
Physicians should be extremely cautious with marketing language. While phrases like “priority care” and “unlimited access” may be appealing, they carry significant legal implications. If you advertise services or access levels that you cannot consistently deliver, your practice could be accused of misleading marketing, which is a violation of Florida healthcare advertising laws. It’s critical to align your promotional language with your actual service capabilities, and to disclose any limitations in writing. Avoid using absolutes or guarantees unless they are clearly defined and operationally realistic. When in doubt, have your marketing materials reviewed by a healthcare attorney to avoid potential compliance issues.
Final Thoughts: Should You Pursue Concierge Medicine in Florida?
Concierge medicine can be a sustainable, patient-focused model, but it requires strict legal oversight in Florida. It offers physicians the opportunity to build deeper relationships and more flexible practices, but only when executed with full compliance in mind.
The difference between a thriving concierge practice and one shut down by regulators often comes down to legal preparation. If you’re ready to build a high-touch, personalized care model, the most important first step is understanding Florida law—and applying it rigorously.
Contact Rafferty Domnick Cunningham & Yaffa Today
If you are a physician considering concierge care in Florida, don’t take legal shortcuts. The best way to protect your license, your business, and your patients is to speak with a qualified healthcare attorney who understands Florida’s regulatory landscape.
Concierge medicine offers freedom—but only for those who know how to operate within the law. Schedule a legal consultation before you launch or expand your practice. It could be the most important investment in your medical career.
