Early Termination of Opt-Out

40.35 - Early Termination of Opt-Out (Rev. 222, Issued: 05-13-16, Effective: 08-15-16, Implementation; 08-15-16) If a physician or practitioner changes his or her mind after the Medicare contractor has approved the affidavit, the opt-out may be terminated within 90 days of the effective date of the affidavit. To properly terminate an opt-out, a physician or practitioner must: • Not have previously opted out of Medicare; • Notify all Medicare contractors, with which the physician or practitioner filed an affidavit, of the termination of the opt-out no later than 90 days after the effective date of the initial 2-year period; • Refund to each beneficiary with whom the physician or practitioner has privately contracted all payment collected in excess of: º The Medicare limiting charge (in the case of physicians or practitioners); or º The deductible and coinsurance (in the case of practitioners). • Notify all beneficiaries with whom the physician or practitioner entered into private contracts of the physician’s or practitioner’s decision to terminate opt-out and of the beneficiaries’ rights to have claims filed on their behalf with Medicare for services furnished during the period between the effective date of the opt-out and the effective date of the termination of the opt-out period. When the physician or practitioner properly terminates opt-out in accordance with the second bullet above, the physician or practitioner (who was previously enrolled in Medicare) will be reinstated in Medicare as if there had been no opt-out, and the provision of §40.3 must not apply unless the physician or practitioner subsequently properly opts-out.