Medicare Patient Choice: Direct Contracts with Doctors and Reimbursement Option.
This bill creates a new option for Medicare beneficiaries to enter into private contracts with eligible professionals for covered services. While increasing freedom of choice, beneficiaries must agree that standard Medicare price limits do not apply, potentially leading to higher out-of-pocket costs, though they can still submit claims for Medicare reimbursement. The contract must be established in writing before services are provided.
Key points
Allows Medicare beneficiaries to sign direct, written contracts with any eligible professional for covered services, regardless of the doctor's participation status in Medicare.
Beneficiaries can submit claims to Medicare for reimbursement, but they are responsible for the full negotiated fee, which may exceed standard Medicare limits.
The option is unavailable during medical emergencies or for individuals eligible for both Medicare and Medicaid (dual eligibles).
The law overrides state regulations that limit the fees doctors can charge under these specific contracts.
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