Here is an interesting story from the New York Times about alleged Medicare fraud, including waiving co-pays. $18,000,000 paid to one doctor in one year. How the hell could he do that many procedures😜
But here are the real issues, the unnecessary care provided to all those patients and the fraud resulting from waiving the patients co-insurance payment.
What’s that you say, being a nice guy is fraud.⁉️ It sure is. A doctor or facility cannot waive deductibles or co-payments. If they do, it’s fraud; either a violation of their contract with insurance companies or violation of Medicare rules.
What’s the big deal you ask? Well the logic goes if the doctor can waive these payments he can reduce his fee paid by your insurance. In addition, the purpose of deductibles and co-payments is in part to encourage you to be more prudent in spending money on health care. If a doctor waives the payments, you may care less what services he provides or how much is provided (logic alien to me, but real nevertheless). More health care is not automatically better health care, but it does generate revenue for health care providers.
So if you are inclined to seek such waivers or are offered this deal, think twice before accepting. Even though your doctor may be a nice guy, you may be participating in fraud
And here is another point to ponder. My wife as talking with a group of elderly women the other day. The conversation meanders to Medicare. The general consensus was that Medicare was great; “it just pays everything” the women delightedly exclaimed. Indeed it does, and that’s why relying primarily on retrospective review of claims such as it is leads to the build up of massive fraud, the stopping of which often requires the actions of whistleblowers years after the fact.
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