Federal law prohibits traditional Medicare and Medicare Advantage providers and suppliers from billing people who are qualified Medicare beneficiaries (QMBs) for Medicare deductibles, coinsurance and copayments — a practice known as balance billing. Qualified Medicare beneficiaries (QMBs) are people with Medicare who have incomes at or below 100 percent of the federal poverty level — or a higher level set by their state — and very few resources. In spite of the prohibition, many QMBs are receiving and, out of fear, paying these bills.
The U.S. Senate unanimously approved legislation Monday night requiring hospitals across the nation to tell Medicare patients when they receive observation care but have not been admitted to the hospital. It’s a distinction that’s easy to miss until patients are hit with big medical bills after a short stay.
Medicare could save $560 million or more a year simply by allowing some patients who call 911 for an ambulance to be taken somewhere other than a hospital emergency room.
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