CMS Pub. 100-02, ch. 15, § 40.35

If a physician or practitioner changes his or her mind after the Medicare contractor has approved the

affidavit, the opt-out may be terminated within 90 days of the effective date of the affidavit. To properly

terminate an opt-out, a physician or practitioner must:

• Not have previously opted out of Medicare;

• Notify all Medicare contractors, with which the physician or practitioner filed an affidavit, of the

termination of the opt-out no later than 90 days after the effective date of the initial 2-year period;

• Refund to each beneficiary with whom the physician or practitioner has privately contracted all

payment collected in excess of:

º The Medicare limiting charge (in the case of physicians or practitioners); or

º The deductible and coinsurance (in the case of practitioners).

• Notify all beneficiaries with whom the physician or practitioner entered into private contracts of the

physician’s or practitioner’s decision to terminate opt-out and of the beneficiaries’ rights to have

claims filed on their behalf with Medicare for services furnished during the period between the

effective date of the opt-out and the effective date of the termination of the opt-out period.

When the physician or practitioner properly terminates opt-out in accordance with the second bullet above,

the physician or practitioner (who was previously enrolled in Medicare) will be reinstated in Medicare as if

there had been no opt-out, and the provision of §40.3 must not apply unless the physician or practitioner

subsequently properly opts-out.