opting out of medicare cade

[PikminOC]

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I can't find where the psychistrists recently discussed this, although I know they did.

In pp, is it better to opt out of medicare/aid?

It is difficult to opt out and i think it lasts 2 years.

Any help would be appreciated.

also, is it really possible to limit the numbers of these patients?

 

[jmadden]

it may depend on the service. Shrinks can opt out intermittently i think, but when they opt in they are paid 5% less or some BS

 

[michaelrack]

I think it is just better to limit or not take medicare. Although I don't have practical experience in the matter, my understanding is that the purpose of opting out of medicare is to be able to charge a medicare patient a higher fee (if you opt out, you basically can charge a medicare patient whatever you want. This is different from being a non-participating physician).

 

[PikminOC]

what about participation in medicaid?

 

[michaelrack]

what about participation in medicaid?

Participating, non-participation, and opting out are terms specific for medicare (and the simplest thing for most psychiatrists to do is to be participating with medicare, but limit the # of medicare pts they take, or don't take them at all-but still maintain participating status)

As far as medicaid, the primary reason for a private practice psychiatrist to be in network with medicaid is if they expect many of their pts to have medicaid as a secondary. (if you don't have any or many medicare pts, most of your pts won't have medicaid as a secondary).


edit: The above applies only to those doing primarily outpt psychiatry

 

[PikminOC]

I found out if you accept medicare, you cannot restrict numbers per the medicare contract.

 

[michaelrack]

I found out if you accept medicare, you cannot restrict numbers per the medicare contract.

This is what I found in a 2010 article:

http://online.wsj.com/article/SB10001424052748704454304575081852533567496.html

"Doctors have three options when it comes to Medicare: They can "participate" (agreeing to accept Medicare's rates, plus the patient's set copay); they can be "nonparticipating" (accepting a lower Medicare fee and charging the patient slightly more) or they can opt out of Medicare and charge patients whatever they want, but can't be reimbursed by Medicare.

Even when doctors do participate in Medicare, they are not obligated to take every Medicare patient who wants to see them. Doctors can run their practices as they see fit, according to a spokeswoman for the Centers for Medicare & Medicaid Services."

I am not aware of any basic medicare contract (private practice) which requires a doc not to restrict medicare patients.
If you sign up for one of the medicare advantage plans, things might be different with that specific plan.

 

[michaelrack]

http://www.kunc.org/post/two-thirds-colorado-doctors-refuse-or-limit-basic-medicare-patients

Many docs are limiting new medicare patients

 

[PikminOC]

thanks for the info..i will have to look into it very carefully as I was accepting these insurances thru the last hospital i worked at

 

[michaelrack]

thanks for the info..i will have to look into it very carefully as I was accepting these insurances thru the last hospital i worked at

There may be some limitations/restrictions on medicare at a hospital based practice that don't apply to a true private practice.