Demographic analysis reveals some differences in the rates at which different types of physicians report accepting new Medicare patients. For example, 83 percent of primary care physicians who self-identify as Asian accept new Medicare patients, similar to the 86 percent among physicians who self-identify as either Black, Hispanic, or of another or multiple races (Figure 2). In contrast, a lower share of white primary care physicians (66 percent) say they are accepting new Medicare patients. Notably, while higher shares of Black and Hispanic primary care physicians accept new Medicare patients, Black and Hispanic physicians continue to comprise a relatively small share of the overall non-pediatric primary care physician workforce.
Opting Out of Medicare: a guide for physicians
I, ______, declare under penalty of perjury that the following is true and correct to the best of my knowledge, information, and belief: 1. I am a physician licensed to practice medicine in the state of ______. My address is at _________, my telephone number is _________, and my [national provider identifier (NPI) or billing number, if one has been assigned, uniform provider identification number (UPIN) if one has been assigned, or, if neither an NPI nor a UPIN has been assigned, my tax identification number (TIN)] is _________. I promise that, for a period of two years beginning on the date that this affidavit is signed (the “Opt-Out Period”) and continuing indefinitely with automatic extensions of the 2-year opt out period unless terminated by me as allowed by Title 1 Section 106(a)(1) Medicare Access and CHIP Reauthorization Act of 2015, I will be bound by the terms of both this affidavit and the private contracts that I enter into pursuant to this affidavit. [NOTE: Your personal UPIN number must be used, not a corporate UPIN number. Persons opt out, not corporations.] 2. I have entered or intend to enter into a private contract with a patient who is a beneficiary of Medicare (“Medicare Beneficiary”) pursuant to Section 4507 of the Balanced Budget Act of 1997 for the provision of medical services covered by Medicare Part B. Regardless of any payment arrangements I may make, this affidavit applies to all Medicare-covered items and services that I furnish to Medicare Beneficiaries during the Opt-Out period, except for emergency or urgent care services furnished to Beneficiaries with whom I had not previously privately contracted. I will not ask a Medicare Beneficiary who has not entered into a private contract and who requires emergency or urgent care services to enter into a private contract with respect to receiving such services, and I will comply with 42 C.F.R. § 405.440 for such services. 3. I hereby confirm that I will not submit, nor permit any entity acting on my behalf to submit, a claim to Medicare for any Medicare Part B item or service provided to any Medicare Beneficiary during the Opt-Out Period, except for items or services provided in an emergency or urgent care situation for which I am required to submit a claim under Medicare on behalf of a Medicare Beneficiary, and I will provide Medicare-covered services to Medicare Beneficiaries only through private contracts that satisfy 42 C.F.R. § 405.415 for such services. 4. I hereby confirm that I will not receive any direct or indirect Medicare payment for Medicare Part B items or services that I furnish to Medicare Beneficiaries with whom I have privately contracted, whether as an individual, an employee of an organization, a partner in a partnership, under a reassignment of benefits, or as payment for a service furnished to a Medicare Beneficiary under a Medicare+Choice plan, during the Opt-Out Period, except for items or services provided in an emergency or urgent care situation. I acknowledge that, during the Opt-Out Period, my services are not covered under Medicare Part B and that no Medicare Part B payment may be made to any entity for my services, directly or on a capitated basis, except for items or services provided in an emergency or urgent care situation. 5. A copy of this affidavit is being filed with [the name of each local Medicare carrier], the designated agent of the Secretary of the Department of Health and Human Services, no later than 10 days after the first contract to which this affidavit applies is entered into. [FOR PARTICIPATING PHYSICIANS ONLY: My Medicare Part B Participation agreement terminates on the effective date of this affidavit.] Executed on [date] by [Physician name] [Physician signature]
Naturopathic Physicians and Medicare
Each year, the number of seniors who qualify for Medicare increases and so does the need to provide them with greater choice in health care. A major AANP legislative priority is to get naturopathic doctors included in Medicare so that seniors can be reimbursed for a type of care that can prevent many types of chronic illness and improve patients’ quality of life by alleviating the need for expensive drugs and surgery. To move toward this goal, the AANP is asking Congress to direct the Centers for Medicare and Medicaid Services to pursue a pilot project that would demonstrate the value of naturopathic care for seniors while saving the government money. A similar pilot project – one conducted by YMCA of the USA on diabetes prevention – is on track to become the first truly preventive approach covered by Medicare. AANP will officially launch this Medicare initiative at our 2016 federal legislative event, the DC FLI, where hundreds of naturopathic doctors and students will visit their members of Congress. The campaign won’t end there, however. In the weeks following the FLI, the entire profession will be called to action. If you are interested in reaching out by phone or email to your Congressional office, please let us know HERE! Please familiarize yourself with the materials on this webpage. AANP thanks you for your passion and your commitment to transform health care – for seniors and for citizens throughout the country. MEDICARE
Medicare Patients’ Access to Physicians: A Synthesis of the Evidence
Nationally, patient and physician surveys and Medicare’s administrative data show that most Medicare patients enjoy good access to physicians and most physicians are accepting new Medicare patients. Moreover, survey findings reveal that Medicare beneficiaries and adults with private insurance report similar access to physicians. While the majority of Medicare beneficiaries report having a usual source of care and do not forego needed physician visits, certain subgroups of Medicare beneficiaries have higher rates of access problems that warrant close attention. These include beneficiaries with no supplemental insurance or Medicaid, beneficiaries under age 65 living with a permanent disability, beneficiaries in fair and poor health, beneficiaries with four or more chronic conditions, and beneficiaries with lower incomes. For the most part, however, even among these subgroups, most do not report significant problems securing access to medical care when needed. Physician surveys and Medicare data tell a complementary story to the patient surveys. Overall 91 percent of physicians report taking new Medicare patients—comparable to the rate for new private non-capitated patients. About 1 percent of physicians have formally opted-out of the Medicare program to contract privately with all their Medicare patients, with psychiatrists comprising the largest share. Factors that influence physician decisions about acceptance of new patients can be strongly influenced by local health market circumstances that cannot be ascertained from state-level data. Further research is needed at a more local level to understand how access is affected by other factors including provider supply, other insurer interactions, changes in group practice dynamics, and patient demand for medical services. Survey instruments could be improved to determine if doctors in open practices access some or all new patients, by type of insurance. While this paper focuses mostly on physicians, the number of other health professionals who provide care to Medicare patients—such as nurse practitioners and physician assistants—has grown rapidly over the past decade.
Medicare Annual Wellness Visit
Answer: See page nine of Transmittal 134: It clearly states who a medical professional is. It seems to leave the door open for some “incident-to” type services such that a nurse or someone without an NCI could perform these services. Indeed, the Medicare Administrative Contractor (MAC) WPS has said that these services can be carried out by an LPN under direct physician supervision, present in the office suite, and CMS in Baltimore has said that these were “intended to be collaborative.” That said, I would get something in writing from your local carrier or MAC before I went down that road.
Medicare's New Annual Wellness Visit
Betsy Nicoletti is the founder of Codapedia.com. She is the author of “A Field Guide to Physician Coding.” She believes all physicians can improve their compliance and increase their revenue through better coding. She may be reached at firstname.lastname@example.org. *Seniors and doctors alike are hot for the highly publicized new wellness visit under Medicare, but a story about claim denials from contractors is apparently causing a bit of alarm. Read, “Watch Out for Medicare Wellness Visit Glitches” to find out the details.
New Medicare Rule Will Reimburse Physicians for Advance Care Planning
Proponents of this new legislation, such as the American Medical Association and the American Academy of Palliative and Hospice Medicine, say that this rule will encourage physicians to make time for these lengthy discussions and facilitate patient choices while improving quality of care for seniors. Opponents, including the Association of American Physicians and Surgeons, contend that such payments will “create financial incentives to persuade patients to consent to the denial of care.”
Geographic Adjustment of Medicare Payments to Physicians: Evaluation of IOM Recommendations