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Comments From VelociDoc About The August 27th, 2007 Posting:

In reference to: “… A visit to a retail clinic in California made earlier this month by an 84-year-old acquaintance did not provide the services she sought. According to a posted notice, federal law excludes Medicare and Medicaid patients from receiving services from retail clinics.”

This is interesting information. At Practice Velocity (www.practicevelocity.com), we provide software solutions for over 500 urgent care clinics, of which some are retail clinics. This is the first that I have heard of a Medicare ban on these clinics. I believe that the clinic may have confused non-participation with legal issues. I do not believe that there is any Federal law that prohibits retail clinics from seeing Medicare patients. Retail clinics that serve Medicare patients may have to deal with several complicating issues:

1) coding would have to use CMS-standard codes

2) incident-to standards would have to be followed

3) compliance issues are more rigorous with CMS

Note: I believe that all providers (even those who have opted out of Medicare) are required by Federal law to treat any Medicare beneficiary who presents with an emergency situation and to bill Medicare for these services.