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Medicare Annual Wellness Visit Required by Law?

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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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.

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I seriously object to these wellness exams. My conglomerate doctors office holds my meds at bay, not approving refills u less I hv a wellness exam scheduled. The appt for this next one will not take place until the end of 2022. You cannot discuss existing conditions or concerns or u are charged and it’s no longer a wellness exam. No list of questions that r relevant r asked. This, in my opinion is simply a money making scheme. I was told it was to make certain I didn’t hv any health concerns and to make certain they were not just refilling meds for patients who do not see their doctor. An organization that size doesn’t know me and doesn’t care. $$$$$

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Recognized Social Butterfly


@GANS1110 wrote:

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


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

 

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


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I had this last year thinking it was mandatory - which I now know IT IS NOT. It was the biggest waste of my time! It's more like a survey. Ex.: do you wear a helmet when riding a bike? do you have safety handles in your tub or shower? do you wear a seat belt while driving? do you know the ratio of fat, protien and carbs in your diet? It was ridiculous!!!

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I never heard of the wellness visit being mandatory, but I suppose it's a good idea. Doesn't amount to much though. They listen to the heart, look down your throat, look in your ears, that's about it. Some exam !  I made an appt. for a physical exam, expecting blood tests, pap smear, etc. ( first full physical in years). All i got was a wellness exam-again. Dr. said she'd skip the pap smear, because 'women my age rarely get that type of cancer'. Think she skipped everything else, too. Some doctor ! I'm in the market for another medical professional-IF I can find one.

Sandee2
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@CindyV865042

 

Right, not mandatory but is it informative to your Medical provider?  How better for your doctor to find out about you and keep down medical cost than ask questions and make note of the answers.

It is Preventive Medicine and includes lots of stuff that could have a bearing on your risk factors.  Sounds like you had the HRA - Health Risk Assessment.

 

These are all the Wellness visits that are either covered by Medicare or not, written as directions to the physicians from CMS - from coding to what is or is not covered by Medicare.  Very informative -

Medicare Learning Network - Annual Wellness Visits Booklet

 

If it is a joke, perhaps we need to get Medicare to stop paying for them and just do like other medical providers do and give you a form to fill out before your visit - on your own time and nickel.  Problem is, it is for all Medicare beneficiaries and many of them cannot fill out a form by themselves.

 

Do you not believe in this sort of Preventive Care, i.e. cutting down on the risk before something bad happens whether or not that is getting a person wear a helmet while ridong a bike or getting their blood pressure taken or taking a detailed family or medical history?

It's Always Something . . . . Roseanna Roseannadanna
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