Inappropriate Billing of QMBs

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Inappropriate Billing of QMBs

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Subject: MAC Reporting of Issuance of Compliance Letters to Specific Providers and Suppliers Regarding Inappropriate Billing of Qualified Medicare Beneficiaries (QMBs) for Medicare CostSharing

Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2019Downloads/R2280OTN.pdf

Number: 2280

Title: 11250

Summary: The purpose of this Change Request is to instruct Medicare Administrative Contractors (MACs) to report on an ongoing basis the issuance of provider compliance letters as first outlined in CR9817 and subsequent technical direction. This CR also instructs the MACs to use the attached revised provider compliance letter, revised explanatory beneficiary cover letter, and reporting templates.

Release Date: April 19, 2019

Effective Date: May 20, 2019

Implementation Date: June 21, 2019 – 30 days after issuance for BR3 and BR4; 10 days after the end of each calendar year quarter for BR2 and BR2.1

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