Medicare Enforcement Starts Now! June 02 2016, 0 Comments

Medicare Enforcement Starts Now!

 The August 2016 Medicare application deadline date is coming up and your patients will soon be asking you about irritating letters they will be receiving from Medicare that will affect your relationship with these patients. The ADA and CMS have strongly encouraged dentists to enroll with Medicare by August 2016 so as not to disrupt the nearly 50 million Medicare Part D patient’s benefits when the February 1, 2017 kicks in.

 Here is a very quick recap of my previous Medicare articles:  1) You need to get this done now; 2) Each practice needs to decide what is best for their practice; 3) Your Medicare patients will leave you if you do nothing; 4) The right choice will bring many new patients to your office.

 Here is what will happen if you do nothing regarding Medicare. After February 1, 2017, the first time a dentist writes a prescription for a patient with a Medicare part D drug plan, the patient will get a provisional supply of the prescribed drugs and will receive a letter stating that the drug will not be covered again after the first three months because the prescribing dentist is not enrolled. You will receive a letter from Medicare as well since Part D plans are also required to attempt to notify the prescribing dentist. After three months, the patient’s Medicare prescription plan will deny coverage of the prescription.  How happy do you think the patient will be with your office?  I can guarantee they will find another dentist very quickly.

If you opt out of Medicare, you will be excluded from the many Medicare advantage dental plans your office has right now. This will force patients to seek other dental providers. These patients will not receive any dental benefits if you opt out of these plans, so they will come to offices like mine who have enrolled in Medicare. You are locked out of these plans for two years! The chances of you ever seeing these patients again are a big zero.

 Medicare STATistics

 Bottom line is you need to submit your Medicare application immediately!  Here are the latest dental statistics from the STATDDS Medicare enrollment specialists who have helped enroll thousands of dentists over the past two and a half years:


  • 97.4% of dentists enrolling in Medicare Part B chose to enroll as an ordering/prescribing provider.
  • 1% of dentists chose to opt out of Medicare.
  • 1.6% of dentists chose to enroll in Medicare as a billing provider.
  • 94% of STATDDS clients who first tried to submit a Medicare application themselves were rejected by Medicare, with the other 6% of this group successfully enrolled into the wrong Medicare choice and now wanted to change enrollment before they lost patients.
  • 38% of dentists enrolling with STATDDS in Medicare part B also chose to submit a Medicare DME application at the same time so that they can bill Medicare for oral appliances for dental sleep medicine.

 Medicare Horror Story

 Here are Medicare horror stories I have heard from dentists.  One dentist submitted the wrong enrollment to Medicare resulting in being locked out of their patients for a two-year period of time.  Another dentist submitted an application with the wrong information resulting in months of rejection letters and hours of wasted time.  One dentist reported he could have produced an additional $10,000 in dentistry in the time that it took him to file and try to correct his Medicare application. He finally gave up and asked STATDDS to step in who finished the application in 3 weeks.

STATDDS reports that Medicare is taking approximately 4-6 months to process Medicare Part B applications.  This means if you begin to get your application together now, you will be able to make the August 1, 2016 deadline which will insure your office will be approved by February 1, 2017 enforcement date.  You can then inform all of your Medicare patients that they can tell all of their Medicare friends that your office can take care of all of their dental needs.

This is exactly why I have been recommending from the start to hire Medicare professionals like STATDDS  so they can get it right the first time. There is no dentist that I know that would do their own legal work, office accounting, or file their own taxes. Outsourcing this to professionals will save you time, money, and aggravation.  Get this done today!


Louis Malcmacher DDS MAGD is a practicing general dentist and an internationally known lecturer and author.  Dr. Malcmacher is president of the American Academy of Facial Esthetics (AAFE).  You can contact him at 800 952-0521 or email   Go to where you can find information about live patient Frontline TMJ/Orofacial Pain, Botox and dermal fillers training, Dental Implant Training, Frontline Bruxism Therapy / Dental Sleep Medicine, Medical Insurance, download his resource list, and sign up for a free monthly e-newsletter.