Subpart D-Private Contracts and Supporting Regulations (CMS-R-234)

Section 4507 of BBA 1997 amended section 1802 of the Social Security Act to permit certain physicians and practitioners to opt-out of Medicare and to provide through private contracts services that would otherwise be covered by Medicare. Under such contracts the mandatory claims submission and limiting charge rules of section 1848(g) of the Act would not apply. Subpart D and the Supporting Regulations contained in 42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, and 405.455, counters the effect of certain provisions of Medicare law that, absent section 4507 of BBA 1997, preclude physicians and practitioners from contracting privately with Medicare beneficiaries to pay without regard to Medicare limits.

The latest form for Subpart D-Private Contracts and Supporting Regulations (CMS-R-234) expires 2021-12-31 and can be found here.

Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410 (a)

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