Medicare Announces Part B Deductible for 2021
Recent legislation signed by President Trump significantly dampened the 2021 Medicare Part B premium increase that would have occurred, given the estimated growth in Medicare spending next year. The standard monthly premium for Medicare Part B enrollees will be $148.50 in 2021, an increase of $3.90 from $144.60 in 2020. CMS also announced that the annual deductible for Medicare Part B beneficiaries is $203 in 2021, increasing $5 from $198 in 2020. Medicare spending is estimated to grow in 2021. People seeking the care they may have delayed during the COVID-19 public health emergency, availability of more COVID-19 treatments, and availability of COVID-19 vaccines, will increase the need for healthcare in 2021. Currently, there are over 67 million people on Medicare. Medicare is the largest of all the insurance carriers as the baby-boomers continue to age.
Toward the end of each calendar year, all Medicare Administrative Carriers (MAC) have an open enrollment period. The open enrollment period generally is from mid-November through December 31. During this period, providers who are currently enrolled in the Medicare Program can change their current participation status beginning the next calendar year on January 1. The enrollment period is the only time enrolled providers are allowed to change their participation status. These providers should contact their MAC to learn where to send the participation agreement and get the exact dates for the open enrollment period during which the agreement will be accepted. New physicians, practitioners, and suppliers can sign the participation agreement anytime and become a Medicare participant at the time of their enrollment into the Medicare Program. The participation agreement will become effective on the date of filing, i.e., the date the participant mails (postmark date) the contract to the carrier or delivers it to the administrator.
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All chiropractors must understand that opting out of Medicare is not an option for DCs. The regulations state:
“Opting out of Medicare is not an option for Doctors of Chiropractic. Note that opting out and being non-participating are not the same things. Chiropractors may decide to be participating or non-participating concerning Medicare, but they may not opt out.” (MedLearn Matters SE0479).
In other words, a provider must be authorized to treat a Medicare patient.
Medicare wants to make sure you are who you say you are, and there are no sanctions or red flags on your license. As physicians, it is crucial to know the facts and not depend on hearsay. Participating should be viewed as being in-network, and non-participating is out-of-network in Medicare. Whether you are in-network or out-of-network, in Medicare, you must file a claim for all active care/treatment or if the patient requests that one be filed. Therefore, since you must file a claim, a cash-only practice is not possible if you are seeing Medicare patients.
References:
Opting Out definition and restrictions. https://med.noridianmedicare.com/web/jeb/enrollment/opt-out
Fraud and Abuse Laws: https://oig.hhs.gov/compliance/physician-education/01laws.asp
Medicare terms defined: https://www.medicareinteractive.org/resources/glossary
