Opt Out Affidavits
Opt Out of Medicare Enrollment
Physicians and practitioners who do not wish to enroll in the Medicare program may “opt-out” of Medicare. This means that neither the physician/practitioner, nor the beneficiary submits the bill to Medicare for services rendered. Instead, the beneficiary pays the physician/practitioner out-of-pocket and neither party is reimbursed by Medicare. A private contract is signed between the physician/practitioner and the beneficiary that states, that neither one can receive payment from Medicare for the services that were performed. The physician or practitioner must submit an affidavit to Medicare expressing his/her decision to opt-out of the program. For more information please review MLN Matters Number: SE1311 (PDF).
Opt out periods last for two years and cannot be terminated early unless the physician or practitioner is opting out for the very first time and the affidavit is terminated no later than 90 days after the effective date of the physician or practitioner’s first opt out period.
Opt-out affidavits signed on or after June 16, 2015 will automatically renew every two years. Therefore, physicians and practitioners that sign valid opt-out affidavits on or after June 16, 2015 will no longer be required to file renewal affidavits. Physicians and practitioners that file valid opt-out affidavits effective on or after June 16, 2015 and do not want to extend their opt-out status at the end of a two year opt-out period may cancel by notifying all Medicare contractors with which they filed an affidavit in writing at least 30 days prior to the start of the next two year opt-out period.
Section 106(a)(2) of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires that a list of all physicians and practitioners that have chosen to opt-out of Medicare be made available to the public.
For a listing of all physicians and practitioners that are currently opted out of Medicare, visit https://data.cms.gov/dataset/Opt-Out-Affidavits/7yuw-754z.