Practice Roundup—Fewer doctors opt out of Medicare; Congress fails to act on community health center funding

Medicare enrollment form
Fewer doctors opted out of Medicare 2017, but it's not clear why. (Image: Getty/zimmytws)

Fewer doctors opt out of Medicare participation

The Centers for Medicare & Medicaid Services (CMS) saw a sharp decrease in the number of doctors and other clinicians opting out of participation in Medicare in 2017.

Whether that is an indication more doctors want to stay in Medicare or a result of a change in the opt-out process remains to be seen.

One theory why the numbers decreased is that under the Medicare Access and CHIP Reauthorization Act (MACRA) providers no longer have to submit an opt-out affidavit every two years. Now once doctors opt out, it’s indefinite unless they decided to rejoin the program.

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Nonetheless, according to CMS data the number of providers opting out dropped to 3,732 in 2017. Physicians and clinicians who do not want to participate in Medicare sign an affidavit that prevents them and beneficiaries seeing them from submitting bills to CMS. The number of opt-outs was 3,500 in 2015 and spiked to 7,400 in 2016.

CMS didn’t offer any explanation for the dip in opt-outs in 2017. “It’s not always easy to tell why government data fluctuate like this,” Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, said in an email to FierceHealthcare, but he speculated it could be related to the MACRA policy. “Figures from 2015 and 2016 may represent the first wave of physicians opting out. Lower 2017 data may reflect the fact that physicians no longer need to file affidavits to renew,” he said. (CMS data)

AAFP chair: Congress must fund community health centers

Congress finally approved a six-year extension for the Children’s Health Insurance Program, ensuring nearly 9 million kids have access to healthcare, but the next step is to provide stable, long-term funding for other programs that are vital to primary care, writes John Meigs, Jr., a family physician in Alabama and board chair of the American Academy of Family Physicians.

Funding for the Teaching Health Center Graduate Medical Education program as well as for community health centers and the National Health Service Corps expired in September, Meigs writes. Without those funds, “will children in communities like mine be able to access the care they need?” he asks. The inaction by Congress threatens training for family physicians, he says. (AAFP blog post)

CMS expands areas for MIPS-reporting exemption because of disasters

The Centers for Medicare & Medicaid Services announced this week that it will expand the number of clinicians who will get an exemption for submitting MIPS data because of a series of natural disasters.

CMS announced an update to its Extreme and Uncontrollable Circumstances Policy for the 2017 Merit-based Incentive Payment System transition year to include counties in Alabama and Mississippi affected by Hurricane Nate and additional counties affected by the California wildfires. CMS said it understands that living in an area were these disasters took place may impact clinicians’ resources to collect or submit data on time.

CMS added 25 counties and clinicians living in those disaster areas will automatically qualify for the exemption. The newly added counties are as follows:

  • Alabama: Autauga, Baldwin, Choctaw, Clarke, Dallas, Macon, Mobile, and Washington
  • Mississippi: George, Greene, Hancock, Harrison, Jackson, and Stone
  • California: Butte, Lake, Mendocino, Napa, Nevada, Orange, Santa Barbara, Solano, Sonoma, Ventura, and Yuba

(CMS fact sheet - PDF)

Health experts call on Facebook to turn off kids’ messaging service

In a letter (PDF) to Mark Zuckerberg, pediatric and mental health experts appealed to the Facebook CEO to dismantle a messaging service introduced last month for children as young as six years old.

The experts argued that Messenger Kids preys on a vulnerable group developmentally unprepared to be on the social network. (New York Times article)

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