Docs have option to switch Medicare status midyear

by Brendon Nafziger, DOTmed News Associate Editor | June 29, 2010
Doctors have more
leeway in switching status
Doctors who switched to non-participating status because they calculated it was the best way to make the most of Medicare funding woes, but whose balance sheets might change in light of the increase in Medicare reimbursements, have a brief window to return to participating status, the Centers for Medicare and Medicaid Services said Monday.

To let doctors take advantage of the 2.2 percent increase in Medicare funding, and a nearly six-month freeze on cuts that lasts until Nov. 30 thanks to the passage of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, CMS is letting doctors enter participating status outside of the normal window, CMS announced.

Typically, CMS only lets physicians and practitioners change their status once at the end or beginning of the year. The doc's decision is then binding for the following year.

Non-participating status is a kind of Medicare status that lets doctors charge an effective 9.25 percent premium on some Medicare claims at the cost of having to bill the patients, instead of getting reimbursed directly by Medicare.

The opportunity to change from non-par to par status is available now until July 16.