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When Medicare Makes You Lie

07/04/2019

If you have Medicare, you have probably encountered a series of questions entitled Medicare Secondary Payer Questionnaire you must answer before most appointments:

  1. Are you receiving Black Lung (BL) benefits?
  2. Are the services to be paid by a government research program?
  3. Are you entitled to benefits through the Department of Veterans Affairs (DVA)?
  4. Was the illness/injury due to a work-related accident/condition?
    1. [If no to 4. above] Was the illness/injury due to a non-work-related accident?

I suppose most patients would know the if they "are receiving" BL benefits.

For 2. I am not so sure.

I would imagine most patients who are entitled to VA benefits know of their entitlement.

But I have a problem with 4. Even the physician may not know the cause of many illnesses, including whether an injury caused it, especially if it occurred in the distant past. Forensic experts charge substantial fees just to offer an opinion as to the cause of an illness, especially when it might have resulted from a work-related incident. 

Medicare forces the patient to make a statement, even when they want to reply, "I don't know." In other words, they must lie.

CMS, the agency that administers Medicare, could easily remedy this, either by adding "I don't know" as a response, or by asking the physician instead of the patient. (And of course the physician may not know either.) Alternatively, they could ask whether the patient wants to claim what caused the illness or injury.

This kind of bureaucratic negligence makes many suspicious of moving toward "Medicare for all."