Careful on Medicare Charges

Physician's Money Digest, May 15 2004, Volume 11, Issue 9

Physicians who participate in Medicare areallowed to charge patients for items and servicesthat aren't covered by Medicare. They can also collectany deductibles and coinsurance amounts dueunder the program without running afoul of theterms of their assignment agreements. However,physicians who charge an additional amount for aservice that is covered by Medicare can be at risk forsubstantial federal penalties.

What brought the issue to a head, according toan alert issued by the office of the Inspector Generalfor the US Department of Health and HumanServices, was a run-in with an internist who askedpatients to sign a yearly contract and pay an annual$600 fee for services not covered by Medicare. Afterthe Inspector General's office concluded that manyof the services were covered by Medicare, the doctorhad to pay more than $50,000 in civil penalties.