Physicians Have Until Mid-February to Reconsider Medicare Status

Family physicians now have until Feb. 14 to change their status as participating or nonparticipating Medicare providers. CMS has extended the Medicare participation enrollment period for physicians until the middle of February in light of updates in the 2007 Medicare Physician Fee Schedule and Congressional action in December.

Specifically, Congress acted last year to freeze the 2007 Medicare physician payment conversion factor at the 2006 level, thus avoiding an expected 5 percent cut in the conversion factor. Additionally, changes in the work relative value units, or RVUs, and the practice expense RVUs resulted in a 5 percent pay increase for family medicine, according to Kent Moore, AAFP manager of health care financing and delivery systems.

"CMS hopes the stable conversion factor and the RVU changes will persuade physicians to remain -- or to become -- Medicare participating providers," Moore said.

According to a recent issue of CMS' online publication Medlearn Matters (PDF file: 3 pages / 90 KB. More about PDFs.), changes in a physician's participation status will be effective Jan. 1, regardless of when during the enrollment period the participation decision is made. The revised fees under the 2007 Medicare physician fee schedule are effective for services provided on or after Jan. 1.

Physicians who choose to become Medicare participating physicians can access the participation agreement -- the CMS-460 form -- from their copies of a CD that was mailed to all physicians in November 2006. Physicians also can request the form from their local Medicare contractors.

Participating physicians who want to change their status to nonparticipating must notify their Medicare contractor in writing of their decision.