Federal law prohibits all Medicare providers and suppliers, including pharmacies, from billing Medicare beneficiaries in the Qualified Medicare Beneficiary (QMB) eligibility group for Medicare Part A or Part B cost sharing. This includes Medicare Part A and Part B deductibles, coinsurance, and copays.

All Original Medicare (also called Fee-for-Service Medicare) and Medicare Advantage (MA) providers and suppliers must:

• Make sure that QMBs are not billed for Medicare cost sharing.
• Take action to remedy any QMB billing or collections.

To do this, providers and suppliers should:

• Implement processes to ensure compliance with QMB billing prohibitions.
• Make sure their office staff and vendors are using systems to identify the QMB status of Medicare beneficiaries.

All in-network providers are responsible for verifying the eligibility of their patients with Cigna Healthcare^℠ Medicare Advantage benefits for each visit. The following channels are available for verifying patient eligibility and benefits:

• Cigan Healthcare Medicare Advantage provider portal: HSConnectOnline.com
• Cigna Healthcare Medicare Advantage Provider Customer Service: 800.230.6138

For more information on the prohibition on billing QMBs, access the Centers for Medicare & Medicaid Services (CMS) fact sheet.