Medicare Annual Wellness Visit Required by Law?

I transitioned to Medicare last summer, and never heard of any mandatory screenings, nor do I intend to have any.

Malignant ignorance.  Yet another example of the hubris, temerity, disrespect, lack of ethical & moral compass in this perverted " healthcare system" .    As a career professional that spans 45 years in medicine , always an advocate for my patients-----I am embarrassed for you.

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@GANS1110 wrote:

Trying to determine if medicare patients have the right to refuse the annual wellness visit or is it mandated by law?

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Just out of curiosity, what kind of punishment did you envision for violating this hypothetical law?

This isn't a laughing matter to me.  My healthcare provider sold out to a big St. Louis for profit organization. Now they are taking steps to increase profit, and one of those steps is to require a Medicare annual wellness visit with each routine physical. For 3 or 4 years they honored my request that I didn't want or need the wellness visit. Now they have decided that I must take it or else.... 

My last physical 1st the nurse told me my insurance might not pay for my physical if I didn't take the wellness visit. I called my insurance they didn't even know what she was talking about.

I refused, my Doctor told me Medicare WANTED them to give the exam. I called Medicare, they said they didn't want or require us to do anything, not even go to the Doctor.

Since they aren't allowed to do a Physical and wellness check on the same visit, they charge you for a co-pay and your insurance provider for an additional office visit, which you don't get.  The Wellness check only consists of a questionnaire asking if you needed help recently to do daily tasks. My Doctor sees me twice a year and KNOWS my physical condition .According to Medicare any charges to medicare that you don't want or need is billing fraud. I believe medicare fraud is so rampant it;s impossible for Medicare to address the issue.

So I'm left to either stop taking a physical of let them use my account to defraud Medicare. 

There is another provider here locally bur I have been going to the same place since mid 70's and all my records are there.

Am I glad to see this discussed! Because my wife and her daughters who live nearby are all physicians, I balk at wellness visits. After innocently going the first year, PCP’s office has tried numerous things including lying by saying they’re mandatory. Most recently had some young male (hired specifically for this purpose?) call out of the blue to ask questions my PCP “forgot to ask on my last (4-5 months prior) visit”.

Medicare fraud anyone?

On another quasi related note: after developing an allergic respiratory response to Covid, PCP prescribed an expensive inhaler. My supplemental plan covered the initial prescription, but nothing thereafter. Upon needing a refill and leaving numerous VM’s to PCP for help without response, my only option was to drive 1/2 hour each way to his office to get a prescription for an older equally effective med. It cost 1/10th what the first one did. 

Medicine in the US isn’t dying, it’s dead. Wife’s daughters tell countless horror stories. 

As a retired internist, I'm very familiar with AWV coding, and an AWV is certainly not "required by law".  However, it may be required by your physician for several reasons: strongly encouraged by Medicare, required by physician's corporate (hospital system) employer, monetary incentive (high reimbursement by Medicare for minimal physician work), grading of physicians by metrics.  The charge entered on the claim filed with Medicare is by the HCPCS code G0439, which should be reimbursed in full by Medicare. Medicare's required components of the AWV are primarily questions and heath risk assessments, as well as promotion of Medicare's screening benefits, such as mammagrams.  There were never any required physical exam components, so it was left up to the physician to determine what would be done, which was highly dependent on time. To get a preventive care physical exam, the physician could use the CPT code 99397, which would never be reimbursed by Medicare. However, there is a way the physician can address new medical complaints, followup of chronic problems or even a complete exam by coding an "evaluation and management" CPT code 99214 or 99215 with a -25 modifier indicating that service was done at the same time as the AWV.  It's up to the physician to allow for sufficient time to do both, but the employer may not allow physicians to control their schedules.  The additional E&M service with -25 modifier should be covered by Medicare with the usual co-pay which would covered by the supplemental.