Can organizations that furnish physician or practitioner services opt out?

No. Corporations, partnerships, or other organizations that bill and are paid by Medicare for the services of physicians or practitioners who are employees, partners or have other arrangements that meet the Medicare reassignment-of-payment rules cannot opt out since they are neither physicians nor practitioners. Of course, if every physician and practitioner within a corporation, partnership [...]

By |2017-06-08T17:49:18+00:00June 8th, 2017|0 Comments

What happens if a physician or practitioner who opts out is a member of a group practice or otherwise reassigns his or her Medicare benefits to an organization?

  Where a physician or practitioner opts out and is a member of a group practice or otherwise reassigns his or her rights to Medicare payment to an organization, the organization may no longer bill Medicare or be paid by Medicare for the services that physician or practitioner furnishes to Medicare beneficiaries. However, if the [...]

By |2017-06-08T17:49:14+00:00June 8th, 2017|0 Comments

Can physicians or practitioners who are suppliers of Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS), Independent Diagnostic Testing Facilities (IDTFs), clinical laboratories, etc., opt out of Medicare for only these services?

No. If a physician or practitioner chooses to opt out of Medicare, it means that he or she opts out for all covered items and services he or she furnishes. Physicians and practitioners cannot have private contracts that apply to some covered services they furnish but not to others. In addition, because suppliers of DMEPOS, [...]

By |2017-06-08T17:49:09+00:00June 8th, 2017|0 Comments

Who can “opt out” of Medicare under this provision?

Certain physicians and practitioners can "opt out" of Medicare. For purposes of this provision, physicians include doctors of medicine, osteopathy, optometry, podiatric medicine and doctors of dental surgery. Practitioners permitted to opt out are physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse midwives, clinical social workers, and clinical psychologists.

By |2017-06-08T17:49:05+00:00June 8th, 2017|0 Comments

How do the private contracting rules work when Medicare is the secondary payer?

When Medicare is the secondary payer, and the physician has opted out of Medicare, the physician has agreed to treat Medicare beneficiaries only through private contract. The physician or practitioner must therefore have a private contract with the Medicare beneficiary, notwithstanding that Medicare is the secondary payer. Under this circumstance, no Medicare secondary payments will [...]

By |2017-06-08T17:48:55+00:00June 8th, 2017|0 Comments