Medicare Assignment Rules

VII. Key Issues: Regulation & Reform >> B. Health Care Regulation >> Health Professionals Regulation >> Medicare Assignment Rules (last updated June 15, 2014)

Overview

Medicare payment rules, including the ban on balance billing and restrictions on private contracting, have evolved in conjunction with changes in the Medicare fee schedule. Absent a cap on balance billing, there were concerns that any future efforts to slow down growth in physician fees might be met by physicians shifting an ever-rising share of the burden onto Medicare beneficiaries. Likewise, restrictions on private contracting foreclose the possibility that physicians will evade restrictive Medicare payment rules by simply making private arrangements with their Medicare patients. The Duke Center for Health Policy and Inequalities Research has developed a draft working paper assessing the costs and benefits of Medicare assignment rules (P1-Medicare Assignment Rules).

Links

• Medicare Participation Options for Physicians (AAFP)