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Docs Billing Medicare Patients Directly? CMS Looks to Allow It

News  |  By Steven Porter  
   April 24, 2018

The new request for information follows up on an RFI last fall that received more than 1,000 responses.

The Centers for Medicare & Medicaid Services announced Monday that it is looking to allow physicians to contract directly with the Medicare beneficiaries they serve.

The agency issued a request for information, giving the public a month to comment on details of how the CMS Innovation Center could design and release a direct provider contracting (DPC) payment model. The request follows up on an RFI last fall that received more than 1,000 responses.

“We recognize that the best ideas don’t come from Washington, so it’s important that we hear from the front lines of our healthcare system about how we can improve care,” CMS Administrator Seema Verma said in a statement.

Cathleen London, MD, who has an office in the town of Milbridge, Maine, said the DPC undertaking would save "a huge amount of money" and reduce hassle for physicians, according to comments CMS published Monday.

"I have not opted out of Medicare but am offering Direct Primary Care to an underserved population in rural Maine," London wrote. "I would like to be part of the CMS DPC Initiative for both Medicare and Medicaid (I have a large Medicaid population) as I think this would decrease my burden as a small office and give better patient satisfaction and care."

The follow-up RFI includes 22 specific questions for which CMS is seeking feedback. It asks how a DPC model could be designed to attract a wide variety of physicians and practices, what support physicians and practices would need from CMS in order to participate in such a model, and more.

Comments will be accepted through May 25.

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.

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