decisionhealth Newsletters, Part B News - 2025 Issue 2 (February)
Can you force patients to get an AWV? Not without risk.
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Article Overview
This premium article reviews a dispute over whether a practice may require annual wellness visits for Medicare and Medicare Advantage patients as a condition of continuing care. It explains the general legal and reimbursement context, including CMS-related reporting concerns, MIPS, HEDIS, and Medicare star ratings, and it highlights the potential practice-management and licensing risks involved. The piece is aimed at physicians, practice administrators, compliance staff, and health care attorneys who need to understand the boundaries between patient outreach and mandated participation.
Why This Topic Matters
Annual wellness visit completion can affect quality reporting, practice metrics, and reimbursement, but attempts to make the visit mandatory may create regulatory, licensing, and patient-abandonment concerns. Understanding the article helps practices balance performance goals with patient choice and compliance risk.
What You Will Learn
- How annual wellness visits relate to Medicare and Medicare Advantage practice operations
- Why practices may focus on quality reporting and performance metrics tied to preventive care visits
- What legal and compliance concerns can arise when a practice pressures patients to schedule annual wellness visits
- What kinds of patient engagement strategies are discussed as alternatives to coercive policies
Who Should Read This
- Physicians
- Primary care practice administrators
- Medical billing and coding professionals
- Health care compliance officers
- Health care attorneys
Codes Discussed
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