317 St. Francis Dr. Suite 350
Greenville, SC 29601

317 St. Francis Dr.
Suite 350
Greenville, SC 29601
Tel: 1-864-235-1834, Fax: 1-864-235-2486

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Medicare Opt Out: Why Doctor Opted Out Of Medicare


I am a Greenville physician who specializes in physical medicine and rehabilitation, complex chronic pain, vascular and regenerative medicine, and serve on the medical staffs of Bon Secours St. Francis Health System and Greenville Health System University Medical Center.

Part and parcel of a physician’s soul is caring for the sick. It’s what motivates one to enter the medical profession. Yet, most citizens who have Medicare coverage today are finding fewer physicians who will accept Medicare patients. In fact, many physicians, including myself, are dropping out of the Medicare program altogether.

Why would a physician who has treated Medicare patients for over 15 years suddenly decide to opt out of the Medicare program?

The federal government, while possibly well intentioned, has now created such a complex maze of Medicare rules and regulations that compliance is practically impossible. By the time the physician figures them out, they have changed. By the time one realizes that they are not in compliance, they are audited.

At this point, the federal government is not concerned that the doctor was not aware of the dynamic rules and regulations. To them, the doctor is committing fraud and will be fined up to $10,000 per line item error.

To add to the frustration of keeping abreast of ever-changing rules and regulations, when a physician has a problem with Medicare, he does not know where to turn for help. Medicare is run by the Center For Medicare & Medicaid Services (CMS), also formally known as the Health Care Financing Administration (HCFA). Their main office is in Washington, D. C., but they have regional offices all over the United States. For example, South Carolina’s regional CMS office is in Atlanta.

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