tci Medicare Compliance & Reimbursement - 2016 Issue 23

Industry Note: CMS Cracks Down on Medicare Providers Caught Overcharging Individuals in QMB

As Medicare shifts from fee-for-service and instead focuses on quality, value-based care under MACRA, CMS continues to push through mandates that protect the beneficiary from nefarious providers and suppliers. In a Nov. 18, 2016 MLN Matters article (MM 9817), a change request was made concerning keeping in compliance when billing a Qualified Medicare Beneficiary (QMB). The initiation of the QMB program, which falls under the realm of Medicaid, was to “assist low-income beneficiaries with Medicare premiums and cost-sharing.” CR 9817 urges MACs to send out compliance letters to providers who persist in overbilling QMBs. Due to confusion...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.