Last Modified: 10/4/2019
Location: FL, PR, USVI
Business: Part B
Title 42, Part 405 of the Code of Federal Regulations (42CFR) outlines the guidelines and requirements for physicians and/or non-physician practitioners who wish to enter into private contracts (opt out). See Private contracts between beneficiaries and physicians or practitioners
for details on who may opt out and what the requirements are surrounding the opt-out process.
First Coast Service Options Inc. (First Coast) has noted a number of common errors on opt-out affidavits that have been submitted, causing delays in the process. The provisions in 42CFR have never provided a form or template for provider wishing to opt out; however, First Coast, working in conjunction with the Centers for Medicare & Medicaid Services (CMS), has developed a form providers may use to avoid costly delays. Click here
to access this
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.