Wiki Charging less than Medicare current fees?

[Bran19]

I believe there is a rule that requires providers to not establish fee schedules that are less than the current Medicare fee for that particular service (or services). I cannot seem to find a reference to this anywhere and was hoping someone might be able to provide that reference or link to me?

Thanks in advance!

 

[mitchellde]

The is a clause called the most favored nation clause that states you cannot charge any amount less than what your stated fee schedule is for any stated entity. Effectively meaning the least amount you charge for any one service cannot be less than what you represent on your fee schedule.

 

[cyndeew]

I think the questioner was asking for compliance information on charging less than your Medicare rate --

Here are some links you should find helpful:

http://oig.hhs.gov/fraud/docs/alertsandbulletins/2004/fa021904hospitaldiscounts.pdf (this info applies to doctors and hospitals and is an alert the OIG put out in response to providers not allowing cash or underinsured patient discounts for fear of violating OIG's policies)

http://www.physicianspractice.com/qa/charging-less-medicare
http://www.martindale.com/health-care-law/article_Fox-Rothschild-LLP_48818.htm

I hope this information is what you were looking for.
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