Medicare Announces Part B Deductible for 2021

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

About Author

Mario Fucinari DC, CCSP, APMP, MCS-P, CPCO

Dr. Mario Fucinari has helped train doctors and staff over the last 20 years. He received his bachelor's degree from Wayne State University in Detroit and his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1986. Dr. Fucinari was the recipient of the 1998 and the 2003 President's Award from the Illinois Chiropractic Society (ICS) for his work with education and training and most recently received the 2012 Chiropractor of the Year award from the ICS. Dr. Fucinari was the first chiropractic physician to attain the Certified Medical Compliance degree. Two years later he earned his degree as a Certified Instructor for the Certified Medical Compliance Program. He is now the Chairman of the Chiropractic division of the national medical compliance program. He has produced classes and publications on HIPAA, Clinical Documentation, Medicare, and Stroke and Cervical Manipulation. He is a worldwide speaker for NCMIC, Foot Levelers, ChiroHealthUSA and several state associations and a Certified Chiropractic Sports Physician [CCSP].Online CME CoursesConnect

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