Medicare Compliance & Reimbursement

Analyze these facts before writing off low income copays. If your practice sees a lot of low income Medicare patients, you may be able to get a helping hand from your state. The 1997 Balanced Budget Act gave the states the choice of whether or not to pay coinsurances and deductibles for Medicare-Medicaid patients, says Atlanta-based attorney Allison Larro. "States can make this decision on their own, so the rules vary depending on location." The Medicare Modernization Act expanded programs for Medicare/Medicaid dual eligibles. There are three programs: • The Qualified Medicare Beneficiary (QMB) program pays premiums, copays, and deductibles for Medicare Parts A and B, for patients with incomes at or below the poverty level. • The Specified Low-Income Medicare Beneficiary (SLMB) program pays Part B premiums for patients with income between 100 and 120 percent of the poverty line. • The Qualified Individual (QI) program also pays Part [...]