Fact Sheet: Improvements in QMB Notices Are Temporarily Suspended

On October 2, 2017, the Centers for Medicare and Medicaid Services (CMS) initiated changes in the Provider Remittance Advice and the Medicare Summary Notice (MSN) to show more clearly that Qualified Medicare Beneficiaries (QMBs) may not be charged for Medicare deductibles and co-insurance. Unfortunately, CMS will be temporarily suspending these system changes as of December 8 because of significant unforeseen issues affecting provider payments. CMS is working to address the problem and reinstate the new systems sometime in 2018.

The temporary suspension of the system improvements does not affect the rights of QMBs. QMBs do not owe deductibles and co-insurance for any Medicare Part A or Part B services.

The suspension also does not affect another change, instituted in November, that enables providers to confirm QMB eligibility before serving individuals, using the same systems through which they check other insurance coverage.

To learn more about these developments, read our fact sheet.

For more information on QMB protections, see the CMS QMB Program webpage. For tools that advocates can use to assist QMB clients who have been improperly billed, go to Justice in Aging’s Improper Billing page.

Katrina Cohens

About Katrina Cohens

Katrina Cohens is based in Justice in Aging’s Washington, DC office and serves as the Database Manager.