Medicare enrollees who are in the Qualified Medicare Beneficiary (QMB) program—a Medicaid program that pays for Medicare costs—should not be billed for health care costs, with a few exceptions. Unfortunately, QMB enrollees often face medical bills that are issued to them improperly.
Recently, the Centers for Medicare & Medicaid Services (CMS) and the Consumer Financial Protection Bureau (CFPB) announced new resources to reduce improper billing of low-income Medicare recipients, giving guidance to providers, plans, and debt collectors, including:
- A new memo that directs Medicare health plans to screen their membership for QMB enrollment and ensure that QMB enrollees are not billed for medical care.
- A new Medicare Learning Network (MLN) resource that advises health care providers of their responsibilities under federal law to not bill QMB enrollees. Providers are directed to pay back money collected as a result of improper billing and recall bills sent to collection agencies.
- A joint statement from CMS and CFPB that reminds debt collectors that debt resulting from improper billing should not be collected and should not be used to tarnish an individual’s credit scores, according to federal law.
Justice in Aging offers a variety of resources on improper billing, including a toolkit with sample letters that can be sent to providers who bill QMB enrollees.
Tagged: