Practice Notes blogger and attorney Martin Merritt points out that September 1 is the current deadline for physicians who wish to opt out of Medicare. And he notes “record numbers are doing just that.”
Merritt provides six reasons physicians are dropping Medicare patients:
1. Forced Pay Cuts. By many estimates, Medicare reimbursement falls far below the cost of providing services.
2. Bureaucratic Nightmare. It’s difficult for physicians to document a patient file sufficiently to satisfy CMS.
3. RAC Auditors. Physicians must return payments, long after the claim has been paid, often because an auditor “with a financial interest in contradicting the physician overrules the doctor.”
4. Stark Law. No Medicare means no need to comply with Stark Law. As a result, physicians can engage in any free-enterprise arrangement, as long as it complies with medical ethics rules.
5. Whistleblowers. As with Stark Law, without Medicare there are no whistleblowers to deal with.
6. Criminal Prosecution. The OIG has redefined fraud to mean “anything the OIG doesn’t like, under the mantra ‘fraud, waste, and abuse.’”
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