Doctors Are Improperly Billing Some on Medicare, U.S. Says

The New York Times: Doctors Are Improperly Billing Some on Medicare, U.S. Says (7/31/2016) Healthcare providers are illegally billing qualified Medicare beneficiaries, also enrolled in Medicaid, for deductibles, co-payments and other costs. The practice, known as “balance billing,” is illegal. Federal law requires doctors to accept the amount paid by Medicare and Medicaid as payment in full for qualified Medicare beneficiaries. Many beneficiaries do not know the practice is illegal and pay the fees. Part of the problem is due to low state Medicaid reimbursement rates. Justice in Aging’s Denny Chan is quoted saying in the piece, “Because of this gap in payment, many doctors and other health care providers try to bill the beneficiaries or refuse to provide services to them.”

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