Declining Medicare patients in private practice?
I am an actively enrolled physician launching a direct-to-consumer service that will primarily offer laboratory and non-acute diagnostic imaging. I want it to be 100% cash-pay, bypass Medicare IDTF rules, and keep my personal enrollment clean for my hospital career.
We strictly refuse all Medicare, Medicaid, and Tricare patients at scheduling. Because we never see federal beneficiaries, the mandatory billing rule is never triggered, and we bypass federal IDTF enrollment.
I plan on owning and playing an admin role while employing third parties to review the intake process (filtering out inappropriate requests as well as Medicare patients), complete phlebotomy (with labs being processed at a partnering lab. I’ve obtained a contract with), obtain and read images.
I’ve heard conflicting advice that I either must formally opt out or ensure the services we offer are totally non-billable to Medicare.
However, given this will be a purely private, elective entity, can I just refuse patients based on their insurance status?
Of course I’ll be seeking legal counsel but would like resources to refer to for myself. Thanks!