decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Medicare Overview / Dropping Out of Medicare
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Article Overview
This article discusses physician concerns about reducing or ending participation in Medicare and summarizes CMS’s general position on Medicare billing obligations. It also addresses private contracting under the Balanced Budget Act of 1997 and the broader compliance considerations that matter to practices serving Medicare beneficiaries.
Why This Topic Matters
It helps physicians, billing staff, and compliance teams understand the high-level Medicare participation framework and the policy issues that arise when providers consider limiting Medicare billing or entering private agreements with patients.
What You Will Learn
- The general Medicare participation concerns that motivate physicians to consider leaving the program
- CMS’s high-level position on provider obligations when treating Medicare patients
- The distinction between informal patient payment arrangements and private contracts
- How the Balanced Budget Act of 1997 is referenced in relation to private contracting
Who Should Read This
- Physicians
- Medical practice managers
- Billing staff
- Compliance professionals
- Healthcare administrators
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