I wish to inform you that after careful consideration I have decided to opt out of Medicare, Medicaid, Tricare, and all other federal medical insurance programs, effective July 1, 2010. In other words, I will no longer accept Medicare, Tricare, or Medicaid insurance. As for the reasons, there are many, and I have highlighted them below.
Once contracted with Medicare, physicians are required to comply with their numerous restrictions and regulations. These rules can be complicated, convoluted, and nonsensical. Oftentimes, these rules force me, against my professional judgment, to treat Medicare and Medicaid patients differently compared to my other patients. For example, allergy vaccines and recommended dosages for Medicare patients are twice the normal volume. This is unnecessary and wasteful.
Medicare and Medicaid require my practice to run differently and inefficiently in certain situations. For example, if I am not in the office and a Medicare/Medicaid patient comes in for an allergy injection, my nurses are not allowed to administer the injection under their rules. In such a situation, Medicare/Medicaid will only allow my Physician’s Assistant to administer the injection. If we are busy, as we often are, this results in long waits for both Medicare/Medicaid patients and the other patients my PA is scheduled to see at that time. If a nurse administers the injection, and we bill for the service like we normally do, Medicare/Medicaid can audit us years later, tell us we are guilty of “insurance fraud” and demand a return of all such payments as well as impose penalties with hefty fines. This is just one example of many such problems that occur on a daily basis because of this rule. Because of regulations like this, it is not only a colossal inconvenience, it is actually a liability for me to participate with Medicare and Medicaid.
It may surprise you to know that Medicare also has a rule that contracted physicians are not allowed to offer discounts to other patients without offering those same discounts to Medicare patients. Consequently, if a patient with little financial resources requests my services, I am currently unable to give that person the substantial discount he or she needs to be able to see me.
By opting out, the burdens of the Medicare/Medicaid rules will be lifted from me and my staff. The need to operate with a different set of rules for a different set of patients will vanish. Quality of care will improve. I will be free to offer significant discounts to patients in financial need. Perhaps most importantly, I will be free to practice medicine and make decisions that I feel are in the best interest of my patients without having to modify those decisions to comply with bureaucratic regulations.
In an effort to make my services more affordable, discounted fees will be offered to Medicare, Tricare, and Medicaid patients effective July 1, 2010. Medicare/Tricare discounts will be approximately 50% off our normal fees. Medicaid discounts will be approximately 95% off our normal fees. Special discounts will be offered to all active duty military personnel and their dependents. All Medicare and Tricare patients wishing to continue care with me after July 1, 2010 will be required (by Medicare) to have a signed contract stating neither the patient nor the physician will try to bill Medicare for any services provided during the specified time. We will have this contract available for any patient who requests one.
Sincerely,
Michael Park, MD