Medicare:

Clarification of Provisions Regarding Private Contracts Between Physicians and Beneficiaries

HEHS-98-98R: Published: Feb 23, 1998. Publicly Released: Feb 25, 1998.

Additional Materials:

Contact:

William J. Scanlon
(202) 512-7114
contact@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

GAO reviewed information about section 4507 of the Balanced Budget Act of 1997 (BBA) and issues regarding beneficiaries' access to physicians and their options for private contracting.

GAO noted that: (1) available information indicates that Medicare beneficiaries have ready access to physicians; (2) overall, about 96 percent of physicians accept and treat Medicare patients; (3) while 4 percent of beneficiaries report difficulty obtaining physician care, the amount that Medicare reimburses physicians does not appear to be the cause of this difficulty; (4) Medicare beneficiaries continue to be able to pay out of pocket whenever they do not want a claim submitted on their behalf or when they want to obtain services Medicare does not cover; (5) in addition, section 4507 of the BBA offers beneficiaries a new option for obtaining services from physicians willing to enter into private contracts; (6) however, much of the information that GAO reviewed on this topic contained inaccurate statements or omitted important details; and (7) for example, several documents falsely claimed that the private contracting provisions of the BBA limit, rather than expand, beneficiaries' options for seeking care from physicians.

Sep 28, 2016

Sep 15, 2016

Sep 14, 2016

Sep 12, 2016

Sep 9, 2016

Sep 6, 2016

Aug 31, 2016

Looking for more? Browse all our products here