MINNEAPOLIS, January 21, 2008—The U.S. House is considering a bill (H.R. 4736) that would override Minnesota state law and allow physicians to balance bill on Medicare services. 

The proposal, which is based on AMA model legislation, would allow physicians who elect not to participate in Medicare to balance bill patients under the Medicare program by removing the current 115 percent limiting charge of the nonparticipating Medicare fee schedule amount. What’s important to Minnesota doctors is that the bill would preempt state laws. 

In most states, physicians have the option of choosing a nonparticipation status that allows them to balance bill patients an additional amount, up to 15 percent, for services in exchange for taking a 5 percent reduction in Medicare reimbursements.
A Minnesota law passed in the early 1990s prohibits physicians from balance billing Minnesota Medicare patients more than the set Medicare reimbursement rate. 

The federal bill introduced in December by Rep. Tom Feeney, R-Fla., on December 17, and was referred to the House Committee on Ways and Means and House Committee on Energy and Commerce.