"Medicare has me by the balls"

Dropping it is bad for business.
Keeping it is also bad for business.

Dropping it means filing notice now (Dec 31 deadline) and collecting cash from your patients. You can only balance bill 15% more than medicare rates, so it is not really ballance billing. Further, your patients pay you and medicare pays them; how many of your patients will burn through the cash or not want to fork it over.

Keeping it might mean that congress then cuts the rates of payment further, and there’s not a damn thing to do about it until next Dec 31 because your stuck with whatever cut they unilaterally make.

Drop it such that your not subject to the 15% ballance bill cap means that you accept nothing for those medicare patients of yours for a full 2 years. This is only an option for those with trivial numbers of medicare patients; thus the decision for this minority would represent little hardship.

Medicare is unlike any other contract. Drop any other contract with a payor and you have no contractual obligation any longer. Patients and payor can take or leave your terms. Drop medicare and terms are still dictated by law, such as limiting your rates you can negotiate with the private individual. The medicare patient is effectively prevented by law from contracting for medical services one to one with a doc.

McClenan did exactly that last year -it’s no secret in Washington, ask our lobbyist at the Mass Med Society.

How low can you go…we’ll we’re nowhere near that yet. I think Medicare can cut rates another 35%-50% before physicians actually opt out to a point where it might have an effect. The AMA statistics about 60% yadda yadda yadda. In reality, most physicians will not -they will just complain a little more loudly.

I dare anyone to post that they are leaving Medicare!!