Charging Beneficiaries for Extra Fees
WPS Medicare has received notification from the Centers for Medicare & Medicaid Services (CMS) Regional Office that they have received inquiries about providers billing beneficiaries extra fees such as a finance charge, interest, or other types of charges.
The CMS Central Office verified that a charge by a physician or supplier for interest on unpaid balances is a violation of Medicare's assignment or limiting charge rules and is also a violation of the physician's or supplier's participation agreement. Medicare views the addition of interest or penalties to a charge for a Medicare covered service to be an increase to the charge for the Medicare covered service and therefore may not be collected by the physician or supplier. This applies to any type of extra fee.
In accepting assignment, providers agree to follow the 42 Code of Federal Regulations (CFR) 424.55. The 42 CFR 424.55 (b)(2)(ii), in part, states the following:
"To collect only the difference between the Medicare approved amount and the Medicare Part B payment (for example, the amount of any reduction in incurred expenses under Sec. 410.155(c), any applicable deductible amount, and any applicable coinsurance amount) for services for which Medicare pays less than 100 percent of the approved amount."The regulation implementing Medicare's assignment provisions is located at 42 CFR 424.55, at the following Website: http://www.gpoaccess.gov/cfr/retrieve.html
Note: The State of Minnesota has a state law levying a two per cent tax on all physicians services rendered to Minnesota residents. The law excludes Medicare covered services from this tax for any potentially Medicare covered services. However, categorically excluded services under the Medicare program can be taxed in the State of Minnesota.
Page Last Updated: Thursday, 18-Mar-2010 05:55:51 CDT
