Common Contracts
1 similar Medicare Opt-Out Agreement contracts
PRIVATE CONTRACT – Medicare opt out April 1, 2022 - 2024Medicare Opt-Out Agreement • March 24th, 2022
This agreement is between Dr. Adrian J. Hohenwarter ("Physician"), whose principal place of business is 745 S. Grant Street Palmyra, PA 17078, and patient and is a Medicare Part B beneficiary seeking services covered under Medicare Part B pursuant to Section 4507 of the Balanced Budget Act of 1997. The Physician has informed Patient that Physician has opted out of the Medicare program effective on April 2022 for a period of at least two years and is not excluded from participating in Medicare Part B under Sections 1128, 1156, or 1892 or any other section of the Social Security Act.
