Opt-out legislation introduced!

Sen. Rand Paul has introduced the Medicare Patient Empowerment Act (S.2812) which permits direct contracting between Medicare beneficiaries and qualified health care professionals.

Under current law, physical therapists are not able to opt out of Medicare. Physicians and other eligible providers are allowed to do so, but they must wholly opt out of Medicare for a two-year (automatically renewable) period. 


The Medicare Patient Empowerment Act would modernize the Medicare statute by allowing a Medicare beneficiary to enter into a direct contract with an eligible professional* (regardless of whether a participating or non-participating physician or practitioner) for any item or service covered by Medicare. The bill provides beneficiaries the option to submit a claim to, and be reimbursed by, Medicare for the amount that would be paid if the professional were a participating practitioner.

The Act prohibits entering into a contract at a time when the Medicare beneficiary is facing an emergency medical condition or urgent health care situation. It also preempts state laws from limiting the amount of charges for physician and practitioner services for which Medicare payment is made.

*Eligible professionals will include: physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse-midwives, clinical social workers, clinical psychologists, physical therapists, occupational therapists, qualified speech-language pathologists, qualified audiologist.

Take Action Today

Contact both of your senators and ask them to cosponsor the Medicare Patient Empowerment Act (S.2812).  A one-pager can be found on PPS’ Advocacy tab.

Send an email and tweet to your lawmakers using these talking points:

The Medicare Patient Empowerment Act (S.2812):

     - Provides patients with greater choice of eligible professionals;
     - Is a patient-centric bill which allows Medicare beneficiaries to contract with any provider at Medicare rates or at rates established between the patient and physician or practitioner.
     - Allows providers to continue as a participating or non-participating Medicare provider with respect to any patient or service not covered under the contract. 
     - Empowers individual beneficiaries at no additional cost to the Medicare program.  In fact, every time a patient opts to not bill Medicare, it SAVES the program money.

     - Contact Zach Bennet in Senator Paul's office to cosponsor


Thank you for your dedication to advocacy and role as a PPS Key Contact!


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