Physicians Won’t be Required to Go Back and Collect Higher Co-Pays From Fee Fix

HHS has waived a regulation that would require physicians to bill Medicare patients for additional coinsurance for June claims, in connection with to the 2.2 percent physician payment increase recently passed by Congress.

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Medicare policy requires physicians to collect a 20 percent coinsurance from Medicare beneficiaries, based on the current allowed fee. The fee increase was enacted on June 25 but is retroactive to June 1, so for three weeks, physicians’ offices did not know a higher copay should be collected.  

The HHS Office of Inspector General has ruled that physicians do not have to go back to patients collect the difference, which would amount to a few dollars for an office visit. The OIG issued a policy statement assuring physicians they “will not be subject to OIG administrative sanctions if they waive retroactive beneficiary liability” subject to the conditions noted in the policy statement.

Read the OIG statement on physician fees.

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