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CMS Extends Deadline to Drop Medicare Participation


Since Congress put delayed making a decision on the Medicare reimbursement cut, CMS is giving physicians until Feb. 14 to decide if they are dropping Medicare participation.

Since Congress has delayed the scheduled Medicare cut so that instead of going into effect on Jan.1 it could go into effect on March 1 (or never depending on what Congress decides), the Centers for Medicare and Medicaid Services is giving physicians a little breathing room also.

Typically physicians would have to decide before the end of a calendar year if they want to drop their Medicare participation agreement. However, CMS has announced that physicians will have until Feb. 14 to become a non-participating physician.

Since physicians' expenses run at least 50% of revenue, and often much more, doctor's pretax income from attending Medicare beneficiaries could be cut by 60% or more.

According to Jane Orient, M.D., executive director of the Association of American Physicians and Surgeons, some organizations, like the American Medical Association are providing calculators to help physicians figure out if they can make more money by dropping their Medicare participation agreement.

“The main reason to take advantage of the extended deadline is that non-par physicians are free to opt out of Medicare at any time, instead of only four times a year, at the beginning of a quarter," Orient said.

According to CMS, if a physician chooses to become non-par by the Feb. 14 deadline then his or her status is retroactive to Jan.1. The AAPS is recommending that any physicians who are unsure should hold off on filing claims until they’ve made a decision. Otherwise they could be faced with an administrative hassle if they file for claims as a participating physician for services after Jan. 1 but then decide to become non-par by Feb. 14.

"Opting out may be the only way a physician can keep his office open, and still be able to serve Medicare-eligible beneficiaries," Orient said. "Without the crushing Medicare compliance costs, physicians can offer personalized, excellent care at a very reasonable price."

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