The Centers for Medicare and Medicaid
Services (CMS) is up to its dirty tricks continually. CMS may become
the laughing stock of the medical care world if they continue to
restrict what health care providers can do. The rules are becoming
so restrictive that even the CMS employees cannot keep up with the
changes. With this, is it any surprise, that Medicare is projected
to be insolvent by 2026, only twelve years from now?
More from the bad news side: Medicare
will not pay for more than one test a year that is not directly
related to the illness currently being treated by the doctor. In
addition, Medicare rules forbid your doctor to treat (and therefore
to test for) more than one ailment per office visit. What is the
patient to do? Many people using Medicare have more that one medical
problem and often three or more.
In theory, the patient could pay for
the additional testing, but if those tests are deemed “medically
unnecessary,” your doctor could go to jail for writing that
prescription if he or she bills Medicare for the test. And if she or
he wants to discuss the results of the test and prescribe a course of
treatment, all discussion and treatment must be about that original
ailment, even if you’re now sick with bronchitis instead. I am
only guessing, but this sounds like if you have more than one
illness, then you will need to see a different doctor for each
disease or illness. How ridiculous CMS is becoming!
If a product or diagnostic test is new,
getting Medicare to create a new billing code for it can take a long
time and cost doctors a significant amount of money in lost
reimbursements. And if a billing code exists, Medicare must agree to
pay for the service. Medicare has not been willing to pay for
genetic testing, except in screening for compatibility for kidney and
bone marrow transplants. And with genetic testing to help
individualize and personalized medicine, Medicare is unwilling to
cover the level of genetic testing need for this to become a reality.
Medicare won't pay for physicians to
consult with patients by email or over the phone, even if the patient
is old, disabled, or too ill to come to the doctor's office.
Medicare will not pay for doctors to teach diabetics how to monitor
their glucose levels or manage their diabetes in other ways. The
same goes for other chronic illnesses.
Read about Medicare and their
restrictions and follow the many links in this article.
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