Traditional MedicareReimbursementMedium impact
Newsletter Vol. 5, No. 20
New Jersey Medicaid·NJ·Reimbursement
We identified it
Jun 20, 2026
Summary
New guidance clarifies that Medicare Part B coinsurance and deductibles should not be collected from Qualified Medicare Beneficiaries (QMB) and dual-eligible patients, as Medicaid covers these costs. Billing teams must identify these patients and adjust collection procedures to avoid improper billing.
Action Required
Immediately: Billing team must update patient registration system to flag QMB and dual-eligible Medicare/Medicaid patients. Stop collecting Medicare Part B coinsurance and deductibles from these patients. Train front desk staff to verify dual eligibility status before collecting payments. Update billing software rules to automatically waive coinsurance for QMB patients.