If you’re one of the physicians who has decided to opt out of the Medicare program, you probably know that you’re expected to file an affidavit with Medicare, noting that you agree to opt out of the program for two years for all Medicare patients. However, if you’ve been searching the CMS website or online portals to find the official corresponding affidavit to complete, you’ve probably come up short.
That’s because CMS “does not have a standard affidavit form,” CMS notes in MLN Matters article SE1311, which the agency issued last week to clear up opt-out issues. “Medicare contractors must instruct those providers who wish to opt out to provide the information mentioned in writing to the Medicare contractor within their service jurisdiction.”
The affidavit must include the following, the MLN Matters article notes:
For more about what you must include in your affidavit, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1311.pdf to read the complete article.