Summary: Under Medicare, physicians have an option on each claim to accept assignment for charges to Medicare patients. By accepting assignment, the physician agrees to accept as payment in full that amount which Medicare determines to be reasonable. In response to congressional concern over the low Medicare part B assignment rate in Connecticut, the following were reviewed: (1) historical assignment rates in Connecticut and other New England States; (2) studies concerning reasons why physicians do or do not accept assignment; (3) a study of the potential effects of mandatory assignment; (4) the effects of mandatory assignment under Medicaid; (5) pending legislative proposals; and (6) other legislative options for increasing assignment rates. Nationwide, the general trend has been a decline in assignment rates. Two studies showed that physicians, in deciding whether to accept assignment, respond to economic incentives or disincentives. Factors affecting Connecticut's assignment rate included the per capita income of the area, uncertainty as to what Medicare's reasonable charges would be, and complicated claims mechanisms. Reasons cited for low participation rates in medicaid involved lower reimbursement rates, lengthy claims processing time, and excessive paperwork. Three options which might have some positive effect on assignment rates are pending in Congress. While it is difficult to determine the specific effect implementation of any option or combination of options would have, the logical step would be to carry out demonstration projects to test the results of various studies.
