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Medicare Balance Billing

May 9, 2011 | No Comments
Posted by Frank Ciesla

A bill was introduced in the House of Representatives last Wednesday, which would permit physicians to balance bill Medicare patients, between what Medicare will pay and what the physician’s charges are for his services. This legislation is being considered by the House Energy and Commerce Committee, as a potential solution to the issue regarding Medicare sustainable growth rate formula, which we have pointed out in prior blogs:

would require a significant expenditure on the part of the federal government. The American Medical Association’s, President Cecil Wolfson, M.D., indicated that such an approach would increase the number of physicians who would be willing to accept Medicare patients. It is clear that a reduction of 20% to 25% in the Medicare fees paid to physicians will result in a significant number of physicians no longer caring for Medicare patients. That obviously, is a major political problem, in that the Medicare population will not have access to healthcare services. However, it is highly unlikely that permitting physicians to balance bill their Medicare patients, will be politically tenable to either the Senate or to the current Administration.


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