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Many chiropractors believe they can simply operate a cash-only practice or have patients sign an ABN form to avoid dealing with Medicare. According to the law, they are completely wrong. In this episode, Wade sits down with Lisa Maciejewski-West from Gold Star Medical, a billing and compliance expert with 44 years of experience in the chiropractic field. Lisa breaks down the harsh reality of Medicare compliance: chiropractors are statutorily prohibited from opting out of Medicare. They discuss the massive compliance risks chiropractors take by operating under the radar, the difference between Participating (PAR) and Non-Participating (Non-PAR) elections, and why offering "free" or discounted non-covered services to Medicare beneficiaries is actually a violation of the federal Anti-Kickback Statute. Episode Chapters: (00:00:51) The "Opt-Out" Myth for Chiropractors (00:03:42) How to Handle Medicare Patients at the Front Desk (00:05:17) Enrolling in Medicare: PAR vs. Non-PAR (00:09:03) Understanding Covered vs. Non-Covered Services (00:11:30) The Anti-Kickback Risk of "Free" Exams (00:12:56) When to Actually Use an ABN Form (00:15:38) How Well-Meaning Patients Trigger Audits (00:21:48) Medicare Advantage vs. Original Medicare (00:26:38) Criminal and Civil Penalties for Non-Compliance