tci Part B Insider - 2016 Issue 6

Physician Notes: CMS: Stop Balance Billing QMB Patients

Plus: Louisiana health network discloses possible HIPAA breach. If you see qualified Medicare beneficiaries (QMBs)—those patients who are eligible for both Medicaid and Medicare—then you should remove the phrase “balance billing” from your vocabulary, at least for your QMB patients. That’s the word from a recent MLN Matters article on the subject. “Despite federal law, erroneous balance billing of QMB individuals persists,” CMS says in MLN Matters article SE 1128, which the agency revised on Feb. 4, 2016. Because QMB patients are exempt from Medicare cost-sharing, you should never balance bill them for...

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