Participation - Non-Participation in Medicare / QMBs_Patients Eligible for Medicaid

Article Overview

This short guidance article covers Medicare participation rules for patients who are also eligible for Medicaid, including the qualified Medicare beneficiary category and related compliance concerns. It is aimed at providers and billing staff who need a basic understanding of when assignment is required and why checking eligibility matters before billing. The article also points readers toward state Medicaid verification resources and the risk of Medicare sanctions when eligibility is overlooked.