Several patients from Bayview Physicians Group said they began receiving monthly bills for a Medicare care-management service that they do not remember agreeing to, while seeing no change in the care they receive.
Some also said Bayview’s instructions for leaving the program suggest they would need to find a new primary care doctor, raising concerns for patients who have spent years, or even decades, with the same physician.
The charges come from Medicare’s Advanced Primary Care Management program, or APCM, which took effect in 2025.
The program allows primary care practices to bill Medicare monthly for services including coordinating care, managing medications, following up after hospital visits and helping patients manage chronic conditions.
WHRO spoke with multiple Bayview patients about the charges.
Joleen Zackowski, a Chesapeake resident, said she and her husband first noticed balances of roughly $9 to $10 appearing on their accounts about a year ago.
At first, she paid the charge without thinking much about it. Only after it continued appearing every month did she begin asking questions.
Zackowski said neither she nor her husband remembers being asked to enroll in APCM or being told beforehand that it could result in a monthly out-of-pocket charge.
“We have not gotten any additional services since they started this service,” Zackowski said. “There is nothing new at all that they are providing.”
William Wright, another Chesapeake Bayview patient, said he began seeing the charge early this year and now pays just under $10 a month over what he was billed before.
Wright said he may have agreed to APCM while signing paperwork during a medical visit, but does not remember a specific discussion about the program or its cost.
Like Zackowski, Wright said he has not noticed a meaningful change in his care.
“If I saw something tangible, if I saw something different, some sort of service, some benefit to this, I wouldn't really have any problem with it at all,” Wright said.
The Centers for Medicare & Medicaid Services said providers must obtain and document a beneficiary’s consent before beginning APCM services. Patients must also be informed that Medicare cost-sharing may apply and that they can stop the service at any time.
In a message sent to patients, Bayview said patients may stop APCM services at any time and that the practice would “provide a transfer of records to your new primary care” provider.
Zackowski said a Bayview billing employee once told her she could opt out and receive her records to take to another primary care physician.
That possibility worries her. Her husband has been seeing the same Bayview doctor for at least 20 years, and Zackowski has seen him for about six.
“He knows us. He really takes the time to know his patients as individuals,” Zackowski said. “It would be heartbreaking to have to find another physician.”
A Bayview billing representative who declined to identify herself told WHRO that the practice obtains patient consent and provides APCM services in accordance with Medicare requirements.
She said Bayview is not currently taking action against patients who do not pay their APCM balances.
Centers for Medicare & Medicaid Services said providers generally may bill beneficiaries for Medicare cost-sharing when a secondary insurer does not cover it, as long as Medicare billing requirements have been met.
In a statement, Bayview’s Patient Advocacy Coordinator Sharon Smith said the practice is committed to providing personalized, coordinated care to patients.
“We recognize that partnering with our patients to help them achieve their health outcome goals is a privilege, and we appreciate each and every patient who chooses Bayview as their primary care home,” said Smith in a statement sent to WHRO.
The practice has not clarified whether a patient can formally opt out of APCM, stop future monthly billing and continue seeing the same Bayview primary care physician.
