this is the strangest set up I have come across, assuming this relationship is NOT your acting as a conservator or some other trust type of arrangement and you are indeed paying the consultant for services of some kind
Even though in real life you are paying third party vendors, you are in fact paying the consultant, and in QB that is how it it needs to be booked. The consultant is set up as a 1099 vendor, and you pay him using an expense account you map to block 7 on the 1099. Who you put on the pay to line of a payment is a different thing and will most likely mean you will need to hand write the checks.
I have no idea about the medicare issue, but I would suggest to you that if you are paying an accountant and he can not clarify things for you, then you either need a new accountant, or consult with a tax accountant, or both.
This is so strange, I suggest you contact a tax accountant locally that you can sit down with and explain the whole thing to.