Is a physician or practitioner allowed to withdraw from the Medicare Program?
(04/01/04) Answer: Yes, but only if certain criteria are met. Under Section 1802 of the Social Security Act, as amended by the Balanced Budget Amendment of 1997, only certain physicians and practitioners were allowed to enter into private contracts with Medicare beneficiaries and “OPT OUT” of Medicare. With the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, 1802(b)(5)(B) of the Social Security Act, dentists, podiatrists, and optometrists were added to the definition/list of physicians who may opt out of Medicare. This went into effect on December 8, 2003. You may see a list of physicians and practitioners who have OPTED OUT of the Medicare program by selecting this link. “Practitioners” permitted to opt out are physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse midwives, clinical social workers and clinical psychologists. Physical therapists in independent practi
(02/15/11) Yes, but only if certain criteria are met. Under Section 1802 of the Social Security Act, as amended by the Balanced Budget Amendment of 1997, only certain physicians and practitioners were allowed to enter into private contracts with Medicare beneficiaries and “OPT OUT” of Medicare. With the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, 1802(b)(5)(B) of the Social Security Act, dentists, podiatrists, and optometrists were added to the definition/list of physicians who may opt out of Medicare. This went into effect on December 8, 2003. You may see a list of physicians and practitioners who have OPTED OUT of the Medicare program by selecting this link. If a Medicare beneficiary sees one of these physicians or practitioners, the beneficiary will be asked to sign a contract, unless the visit is an emergency or urgent situation. The contract makes the patient SOLELY responsible for payment. A beneficiary may not be asked to sign a
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