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Medicare: Private Contracts (CRS Report for Congress)

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Release Date Oct. 21, 1997
Report Number 97-944
Report Type Report
Authors Jennifer O'Sullivan and Cecilia O. Echeverria, Education and Public Welfare Division
Source Agency Congressional Research Service
Summary:

Private contracting is the term used to describe situations where a physician and a patient agree not to submit a claim for a service which would otherwise be covered and paid for by Medicare. Under private contracting, physicians could bill patients at their discretion without being subject to upper limits specified by Medicare. The Health Care Financing Administration had interpreted the law to preclude such private contracts. Some physicians recommended that the law be modified specifically to allow such arrangements.