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On October 31, the Centers for Medicare & Medicaid Services (CMS) and the Consumer Financial Protection Bureau (CFPB) released a joint statement reiterating federal requirements aimed to “protect Qualified Medicare Beneficiaries [QMBs] from improper bills.” QMBs are low-income Medicare enrollees who qualify for state Medicaid agencies to cover their Medicare premiums and Medicare Part A and B cost-sharing. The statement, directed at Medicare providers, Medicare Advantage (MA) plans, and debt collectors, reinforces existing federal requirements that prohibit Medicare providers and suppliers from billing QMBs for cost sharing or sending unpaid bills to debt collectors.
Specifically, CMS and CFPB explain how the Fair Debt Collection Practices Act and the Fair Credit Reporting Act—two laws administered and enforced by CFPB—apply to improper debt collection of QMBs. In particular, the statement articulates that debt collectors may not collect on improper and inaccurate bills targeting Medicare beneficiaries and debt collectors “may not tarnish credit reports with improper and inaccurate bills.”
In conjunction with the agencies’ joint statement, CMS released two new pieces of guidance:
- A CMS fact sheet reminding all Medicare providers—both original Medicare and MA providers—that they may not bill QMBs.
- A new Health Plan Management System (HPMS) memo explaining “plan responsibilities and potential compliance actions related to accurate communication of QMB status to network providers, including pharmacies, and advising them of their responsibility to repay any amounts improperly collected from QMBs.”
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