CMS and Medicare contractors fail to track which physicians are opting out of the program, making it difficult to determine why they are leaving, according to a recent HHS Office of Inspector General (OIG) report.
According to the report, the number of physicians who opted out of Medicare and chose to be paid directly by beneficiaries increased annually between 2006 and 2010. OIG investigators pointed to reduced reimbursement rates, more administrative burdens, and increased fines and prosecutions for fraud and abuse as potential reasons behind the declines. However, they were unable to corroborate their findings because of a lack of centralized and complete data from CMS.
The report warned that "more physicians may opt out in the near future, given the potential for legislated decreases in Medicare reimbursement for physician services."
The report states that OIG will conduct a more comprehensive study into the issue once CMS is able to provide more complete data (Walker, MedPage Today, 1/27; Ethridge, CQ HealthBeat, 1/27 [subscription required]; Selvam, Modern Healthcare, 1/27 [subscription required]).
