tci Medicare Compliance & Reimbursement - 2017 Issue 17

Industry Notes: Build Compliance Standards Into Your Plan for QMB Issues, CMS Says

New guidance from CMS reminds providers that just because you send bills to a Qualified Medicare Beneficiaries, doesn’t mean they have to pay them. In fact, they “have no legal obligation to pay Medicare Part A or B deductibles, coinsurance, or copays for any Medicare-covered items and services,” an updated MLN Matters release says. Reminder: The QMB program, which falls under the realm of Medicaid, was created to “assist low-income beneficiaries with Medicare premiums and cost-sharing.” The feds forbid Medicare Part A and Part B providers and suppliers from billing QMBs. And if you...

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