decisionhealth Newsletters, Answer Books - 2010 Issue 12 (December)
Answer_Book / Copayment_Deductible_Waivers / o
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Article Overview
This article discusses Medicare Part B billing compliance concerns surrounding the routine waiver of copayments and deductibles, including potential scrutiny from CMS and the HHS Office of Inspector General. It explains why collection efforts matter, outlines the general risk areas associated with waived patient liability, and notes that local or state standards may influence what is considered a reasonable attempt to collect. The content is aimed at physicians, DME suppliers, and other Medicare billers reviewing patient cost-sharing practices.
Why This Topic Matters
Routine waiver of patient cost-sharing can affect Medicare payment, trigger compliance concerns, and create exposure to fraud, anti-kickback, or exclusion risk. Understanding these issues helps billers evaluate office collection practices and reduce avoidable compliance problems.
What You Will Learn
- Why routine waiver of Medicare copayments and deductibles can create compliance concerns
- How patient cost-sharing collection efforts are generally viewed in the Medicare context
- What kinds of general enforcement or sanctions may be associated with improper waiver practices
- Why offices may want to review internal billing and collection practices for consistency
Who Should Read This
- Physicians
- Durable medical equipment suppliers
- Medicare Part B billers
- Billing staff
- Compliance staff
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