Medicare Participation Kit

The Centers for Medicare & Medicaid Services (CMS) has announced a six-week extension to the annual Medicare participation enrollment period, which was scheduled to conclude Dec. 31. Physicians’ Medicare participation elections or withdrawals must be postmarked on or before Feb. 14.

This extension comes as Congress averted a 27 percent cut in physician Medicare payments that was scheduled for Jan. 1, preventing the cut for two months as lawmakers work on a longer-term agreement. Read more about the Medicare physician payment patch in a recent AMA alert.

While participation status changes can be made into February, the effective date for these changes remains Jan. 1. Payment rate and other changes associated with becoming a non-participating physician will be retroactive to Jan. 1.

Physicians can use the AMA’s Medicare Participation Kit to help them evaluate their participation options and choose the direction that is suitable for their practice.The kit contains a detailed explanation of physician options, a calculator and various sample materials for communicating with patients. Given the current level of uncertainty, physicians may want to defer making a decision on their participating/nonparticipating status for a few weeks. Physicians have until Feb. 14, 2012 to modify their status.

Medicare Revenue Calculator

Downloads

Know your options: Medicare participation guide

Medicare revenue worksheet

Frequently asked questions about Medicare participation options

Sample letter to patients for practices choosing non-PAR status

Sample letter to patients for practices opting out

Sample letter to patients for practices not taking new Medicare/TRICARE patients

Phone script for practices no longer accepting Medicare/TRICARE patients

Sample Medicare private contract

Sample Medicare private contract "opt-out" affidavit

Medicare Participation Webinar