195.014 Medicare Participation and Nonparticipation


Medicare Participation and Nonparticipation: The Texas Medical Association encourages physicians to continue to render professional services and care to their Medicare patients, as they have done in the past, and as they are doing at this time.

After evaluating present options, TMA believes that the Department of Health and Human Services' reasons for signing as a participating physician are not persuasive.

Consistent with historic association policies, TMA believes that physicians should retain the freedom to consider each patient individually, each case separately, and make independent judgments.

TMA long has taken the position that physicians should be responsible directly to the patient, rather than to the federal government or the fiscal intermediary. This contributes to maintaining and further enhancing the patient-physician relationship.

Recognizing that the decision must be made by each individual physician, TMA believes that most physicians should continue to bill the patient directly for services rendered, or to accept an assignment and to submit a claim to the fiscal intermediary on a case-by-case basis. The association believes this is preferable to signing an agreement as a "participating physician," which mandates the physician to accept assignment in 100 percent of all Medicare cases. TMA believes that Section 2306 of the Deficit Reduction Act of 1984 will seriously jeopardize the availability, accessibility, and delivery of quality medical care (CSE, pp 143-144, A-93; reaffirmed CSE Rep. 6-A-03; amended CSE Rep. 1-A-13).

Last Updated On

October 07, 2016