Attn: All patients 65 years of age and older, or eligible for Medicare due to disability.
Due to concerns with Medicare policies, procedures, and limitations on reimbursement, we have made the decision to dis-enroll from Medicare. Effective May 15, 2016 this clinic no longer accepts new Medicare-eligible patients, and August 01, 2016 we will no longer take appointments for existing Medicare-eligible patients so that we may complete all billing processes prior to officially ending our Medicare enrollment.
Currently, medical providers have four options with Medicare:
- Enrollment as a participating provider
- Enrollment as a non-participating provider (2016 and prior relationship)
- Opt-out (Not available to chiropractors)
- Not enrolled (2016 and future relationship)
Options 1, 2 and 3 may see patients age 65 and over, option 4 may not. At this time, some medical professions have the ability to “opt-out” of Medicare (which means they can still treat Medicare-eligible patients on a time of service payment option); however, Doctors of Chiropractic are not among the professions that are allowed this opt-out option. Due to Medicare rules, once we dis-enroll we are no longer permitted to treat Medicare-eligible patients (which includes any individual 65 years of age and older, or eligible for Medicare due to disability), even under a cash transaction or those holding secondary insurance.
We are very frustrated and saddened by this decision; however, we feel it is the right decision for our business. The American Chiropractic Association (ACA) is currently lobbying to obtain equal coverage for Medicare-eligible patients through the National Medicare Equality Petition. If you wish to sign, go to www.acatoday.org/equality. It takes approximately 60 seconds to complete, and email addresses are protected.
*Information provided is for the benefit of our patients and is given with the intent to assist in decision making when choosing and utilizing healthcare providers. The information provided is based on research by this clinic and our understanding of the information available to us. Pacific West Chiropractic claims no legal or Medicare expertise.