How well do you know your MOM?
In Pennsylvania MOM can refer to:
A. Mind Over Matter
B. Medicaid Operations Measure
C. Master of Mayhem
D. Medicare Overcharge Measure
Answer: D. The Medicare Overcharge Measure, known as the MOM law.
MOM prohibits Pennsylvania doctors from:
A. Having different fee schedules for different payers
B. Closing their practice to Medicare patients
C. Balance billing Medicare patients
D. Releasing the records of Medicare patients without a signed authorization
Answer: C. The MOM law prohibits Pennsylvania physicians from billing Medicare patients more than the Medicare allowance, known as balance billing.
MOM affects:
A. Medicare participating providers only
B. Medicare non-participating providers only
C. Medicare participating and non-participating providers
D. All Pennsylvania physicians
Answer: C. This one is a bit tricky. The MOM Law applies to both Medicare participating and non-participating physicians. Even if you do not participate in Medicare, you are not permitted to balance bill the patient. Answer D is tempting but incorrect. The MOM law does not affect Pennsylvania physicians who do not treat Medicare patients. It is undecided whether it affects physicians who have opted out of Medicare. If you are considering opting out of Medicare and entering into private contracts with Medicare patients by which the patients give up their right to have Medicare pay for their care, you should consult with your attorney. Although Medicare does not impose any fee limitations on physicians who have opted out, it has not been decided whether the MOM law limits you from charging more than the Medicare allowance.
Read more about the
MOM law.