Medicare

You Can't Collect Those Medicare Monies!

It's bad enough that reimbursement is dropping all the time, but now you can't even collect co-pays, deductibles and coinsurance from some Medicare patients.
Medicare Area Contractors (MACs) are receiving increased telephone calls from providers abou the Qualified Medicare Beneficiary (QMB) program.  The QMB program is a State Medicaid benefit that assists low-income Medicare beneficiaries with Medicare Part A and Part B premiums and cost shareing, including deductibles, coinsurance and copays. 
 
Fedral law prohibts Medicare providers from billing beneficiaries who are enrolled in the QMB program for Medicare Part A and Part B deductibles, coinsurance, or copayments. 
 
Providers may bill State Medicaid programs for these costs, but States can limi Medicare cost-sharing payments under certain circumstances.  Additionally, most state Medicaid programs will not reimburse out-of-network, so this means you will need to enroll in the state Medicaid program and the Medicaid managed care plans in order to bill for and receive payment. This is a new wrinkle in some Medicare revenue collection that everyone should be made aware of.  You can find out more about the QMB program here.