Medicare Policy & Forms

Determining the relationship between Comprehensive Gastrointestinal Health and Medicare has been an incredible challenge. For reasons outlined below, I have chosen to opt out of participating with Medicare. This means that Medicare will not pay for you to see me or the other professionals at Comprehensive Gastrointestinal Health.

Please know that I would love to continue providing high quality gastroenterology care to my established or future patients that utilize Medicare. In efforts to facilitate ongoing or future care, I have created a fee structure to enable a continued relationship. I am hopeful that you will find the cost of your occasional visits with me to be affordable.

Please understand there is no one forcing me to do this. Medicare has not excluded me or any member of my team from the program. You will not be restricted in using Medicare with any other physician or for any hospital expenses. This policy only applies to care provided by me and members of the Comprehensive Gastrointestinal Health staff.

This was a very hard choice to make. Unfortunately, my style of practice with longer office visits and increased time spent on education and communication is not valued by Medicare. Over the years, Medicare has gradually reduced reimbursements to the point that some payments are actually below the cost of providing the services. In addition, the ever-increasing administrative burdens placed on doctors have created a difficult situation in which to provide the best quality care. I hope that you will understand why I have made this choice.

I understand that this decision will be a disappointment for many patients and a financial burden for some. I remain hopeful that I will still be able to assist in your care. For those who would like to be treated by me or a member of the Comprehensive Gastrointestinal Health team after September 4, 2018, the Federal Government requires that each patient sign and return to my office the enclosed form which explains that Medicare will not be reimbursing either you or me for any future encounters. I have also included a fee schedule to give you an idea of the charges that will apply if you choose to be cared for here at Comprehensive Gastrointestinal Health.

I understand that some of my Medicare patients may not find this acceptable, and I wish you well establishing care with a physician of your choice. However, I certainly hope to continue to provide your care.

The following Medicare Advantage Plans require participation in Medicare and therefore will NOT be partnered with either:

  • Aetna Medicare (SM) Plan (HMO)
  • Aetna Medicare (SM) Plan (PPO)
  • Aetna Medicare Advantage Group Plans
  • Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
  • Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
  • Aetna Medicare Value Plan (HMO)/HMO Value
  • Aetna Medicare Value Plan (PPO)/PPO Value Plan
  • Aetna Traditional Choice Plan
  • Blue Cross Blue Shield Medicare Advantage Basic HMO
  • Blue Cross Blue Shield Medicare Advantage Basic Plus HMO-POS
  • Blue Cross Blue Shield Medicare Advantage Choice Plus PPO
  • Blue Cross Blue Shield Medicare Advantage Choice Premier PPO
  • Blue Cross Blue Shield Medicare Advantage Premier Plus HMO-POS
  • Cigna-HealthSpring Advantage HMO
  • Cigna-HealthSpring Premier HMO-POS
  • Cigna-HealthSpring Primary HMO
  • Cigna-HealthSpring TotalCare HMO-SNP
  • Community Care Alliance Complete HMO-D-SNP
  • Community Care Alliance HMO
  • Harmony/WellCare Access (HMO-SNP)
  • Harmony/WellCare Choice (HMO-POS)
  • Harmony/WellCare Health Plan
  • Harmony/WellCare RX (HMO)
  • Harmony/WellCare Value (HMO-POS)
  • Harmony/WellCare-Medicare HMO Plans
  • Harmony/WellCare-Medicare Special Needs Plans
  • Humana Choice PPO
  • Humana Community HMO Diabetes and Heart (SNP Program)
  • Humana Gold Plus HMO
  • Humana Gold Plus PFFS
  • Medicare – Part A and Part B
  • Meridian Medicare Advantage
  • Sunrise Advantage Plan of IL
  • United Healthcare – AARP Medicare Complete
  • United Healthcare AARP Medicare Complete Access
  • United Healthcare- AARP Medicare Complete Plus (HMO-POS)
  • United Healthcare Medicare Advantage Focus
  • United Healthcare- Medicare Solutions/Medicare Advantage