If a provider “opts-out” of Medicare, he is permitted to contract privately with Medicare patients or beneficiaries to provide covered services. The beneficiary agrees to pay fully out-of-pocket for a Medicare-covered service after signing a private contract between themselves and the provider/practitioner. They then agree not to submit a claim to Medicare during the prescribed two-year opt-out period, although the service would be covered if a claim were submitted. Potential Fraud/False Claim.