TUCSON, Ariz., March 12, 2013 (GLOBE NEWSWIRE) -- Physicians are increasingly unwilling to serve patients under Medicare's onerous regulations, draconian threats, and poor payment, according to the Association of American Physicians and Surgeons (AAPS). When Medicare was enacted, Congress promised that it would not interfere in the practice of medicine, or prevent patients from freely choosing a physician. California neurologist Susan Hansen, M.D., asks whether these promises are still operative, in the spring issue of the Journal of American Physicians and Surgeons.
Physicians enroll in Medicare by completing a form from the Centers for Medicare and Medicaid Services (CMS), Hansen explains. Some do not enroll, and some disenroll, as by checking a couple of boxes on the form. Such physicians are not "enlisted" in Medicare, states Hansen.
Communications from anonymous Medicare officials strongly imply that such a physician is not allowed to treat a Medicare beneficiary, unless the service is provided free of charge. Nonenrolled physicians who accept a private fee often receive a letter threatening to fine them $2,000 every time they serve a patient without billing Medicare. This amounts to "conscription," Hansen argues.
Worse than the threat of a fine is the possibility that a physician who excludes himself from Medicare may be officially excluded by the government, a punishment that may result in loss of hospital privileges and other career-ruining consequences.
Hansen argues that the liberty of patients and physicians to enter into a private relationship is fundamental to a free society, and is based on centuries of precedent. Moreover, to facilitate nonenrollment would help to mitigate patients' increasing lack of access to services, and also to relieve pressure on the federal Treasury.
"At present, most patients surrender confidentiality and accept government restrictions in return for Medicare payments," states Jane M. Orient, M.D., executive director of AAPS. "But as care in the government system becomes unavailable, more will want a way out."
Government might have difficulty in prevailing in a lawsuit if it tried to assert plenary authority to conscript physicians, Hansen states. But physicians who contemplate nonenrollment need to be aware of the risks.
The Journal is an official publication of the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties, which was founded in 1943.