Letter To My Patients Regarding My Opt-Out of Medicare, Non-adoption of ICD-10, and Plea to Stand With Me

Dear Cherished Patient,

I most humbly request you take a few minutes to read my heartfelt letter to you. Whether I have cared for you for the past 20 years or you are new to the practice, I want you to understand that I value our relationship most highly and regard my service to you as your physician and surgeon as a privilege and a blessing. I honor the Hippocratic Oath and will treat you individually to the very best of my ability with dignity and privacy.

In 1965, President Lyndon Johnson signed the Social Security Act Amendments into law creating Medicare and Medicaid with the promise that the federal government would not interfere in any way with the practice of medicine whatsoever including compensation, administration, or operation of any institution, agency, or person per Title XVIII SEC.1801.

Tragically, over the past 50 years, the government’s pledge to not interfere with the practice of medicine has been broken. The law has been unheeded and continuously altered, such that the practice of medicine in the United States has been fundamentally transformed, commandeered, and all but lost.

October 1, 2015, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services of the Executive Branch of the United States federal government requires implementation of ICD-10, the 10th revision of the International Classification of Diseases and Related Health Problems, a medical cataloging system of the World Health Organization that includes 141,000 diagnosis and procedure codes including W56.22 Struck by Orca, initial encounter, V91.07 Burn due to water-skis on fire, Y92.146 Swimming pool of prison as the place of occurrence of the external cause, V97.33 Sucked into jet engine, X52 Prolonged stay in weightless environment, V95.40 Unspecified Spacecraft accident injuring occupant, and even VO6.00xA for when Grandma gets run over by a reindeer. The costs of ICD-10 implementation are staggering, far outweigh any perceived benefit, and are a vital factor separating financial sustainability from bankruptcy for private medical practices going forward. ICD-10 implementation was fought vehemently and delayed a year, but ultimately, money from lobbyists representing hospitals, IT, and other special interests bought votes and trumped the best interests of America’s patients and physicians.

Government is now virtually extorting physicians in unprecedented fashion. If physicians do not precisely follow government rubrics and implement and comply with everything the Secretary of Health and Human Services says, we are penalized. I am not implementing ICD-10, because it is nonsensical and doing so does not serve my patients first and is not the best utilization of resources. If I implement this nonsensical, wasteful system, what won’t I do? This is my line in the sand. Therefore, as of October 1st, I will be unable to submit claims to CMS for my services to you. I will be forced to opt out of Medicare.

Just as government has broken its pledge not to interfere with the practice of medicine, it has broken its promise to you, our nation’s seniors. On April 16,2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and soon government will be means testing you and charging you increasingly higher monthly premiums for your Part B Medicare.

Government has betrayed us, but we must not betray one another. The preeminent, inviolable relationship that must be preserved exists between patient and doctor. The insurance company-customer and government-subject relationships are secondary by great orders of magnitude. I am asking you to continue in my care. I will provide you with a transparent fee schedule that is fair and reasonable. I will put you and your well-being first, in place of nonsensical, if not harmful, government rubrics that serve the collective good and political ruling class at your expense. I will not violate my pledge to you. Please, stand with me.

If you chose to see me, government requires you sign an affidavit stating that you understand I have opted-out of Medicare and that you will not submit a claim for my services except for emergency or urgent care services.

I cannot continue to enable this perverse, wasteful, dysfunctional system. This is the ultimate in tough love. I pray you will work with me in a new paradigm-shifting, alternate universe where you have an actual doctor and actual medical care in lieu of government-mandated “insurance” that comes with neither. I appreciate your time and consideration of this critical matter.

Warmest Regards,

Kristin S. Held, MD

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5 thoughts on “Letter To My Patients Regarding My Opt-Out of Medicare, Non-adoption of ICD-10, and Plea to Stand With Me

  1. There is nothing I could say that would convey, sufficiently, my (our) understanding and gratitude for your clarity of cause, and explanation of the stakes we face. That you would commit to such at great personal and professional expense, underwrites your character and grasp of your oath. What can we do to support you and those who grasp and commit to the right course of action? Thanking you will never achieve what is intended on any level. Steve and Debbie Hoffelt

  2. Reblogged this on Idea Capitalists and commented:
    Please read Kris Held, MD.’s heartfelt letter to her patients. I applaud Dr. Kris Held for her ethical stand against big government and big insurance takeover of the healthcare system. At the same time it is sad day in America, when freedom of choose the doctor you have entrusted over the years with your well being is jeopardized. Healthcare is being severely compromised by politics and profit.

    Ask yourself how often you are asked to play by the rules in a game where the deck is stacked against you? The deck being, who you can choose to be your healthcare provider, what treatment you can afford, what medication you are allowed to take? Ask yourself whether the tax dollars you have paid into a corrupt system over many years of hard work are being squandered by wasteful government spending and pocketed by special interests, big pharma, lobbyists and corrupt politicians?

    You may think your hands are tied. You have no choice. In America, you always have a choice. That may mean you have to do less of what you want to do and more of what you have to do to preserve America’s future, your children’s future, your grandchildren’s future.

    We need to rid this country of career politicians. Establish term limits. Vote with your wallet against large corporations who have their hands in your pockets. Do business with your neighbors and small businesses who have your best interests at heart. Every election is important, local, county state and federal. Vote. Vote in this next election, vote with your heart.

  3. You are not my personal doctor but I intend to attempt to get my doctor to see the wisdom of this as well and am willing to not use my Medicare and ChampVA except for urgent or emergency care needs. I intend to give my doctor a copy of “the Lost Art/Physicians, Heal Ourselves” posted July 18th, 2015 on the AAPS website or e-mail, I forget which. I don’t trust our government and believe it is only going to get worse. If you know of a doctor near Crossville, TN who has already opted out and understands alternative or functional medicine, I’d be ecstatic to hear about it. I applaud your efforts to be true to your calling and true to the needs of your patients.

  4. I pay much of my limited income for Medicare and a private insurance, BUT I will stand behind you all the way Dr. Held. You have done too much to try to save our health care & our relationship with our physicians. You have been a friend and benefactor in several ways during the years you have cared for my eyes, so I will not leave your good care. May God bless all that you do medically and patriotically for all of our fellow Americans.

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