Medicare News
| For Immediate Release: | Contact: |
| Tuesday, March 02, 1999 | CMS Office of Public Affairs 202-690-6145 |
For questions about Medicare please call 1-800-MEDICARE or visit www.medicare.gov. |
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HCFA URGES PROVIDERS TO PREPARE FOR MEDICARE BENEFICIARY REQUESTS FOR ITEMIZED STATEMENTS
The Health Care Financing Administration (HCFA) is urging physicians, hospitals and other providers and suppliers to prepare for requests from Medicare beneficiaries for itemized billing statements for services.
HCFA officials recently met with representatives from national provider groups, including the American Medical Association, the Federation of American Health Systems and the American Association of Homes and Services for the Aging, to urge them to get the word out to their members about the new policy required by the Balanced Budget Act of 1997.
"We want all Medicare providers and suppliers to be aware of their obligation to provide beneficiaries with itemized statements," said Robert Berenson, M.D., director of HCFA's Center for Health Plans and Providers. "The national groups can play an invaluable role in helping to make sure their members are ready to answer beneficiaries' questions about itemized billing, and we appreciate their help in getting the word out."
While most providers are honest and bill Medicare appropriately, the new policy requiring itemized statements be provided to beneficiaries on request is designed to help Medicare beneficiaries identify incorrect or improper payments for services. The new requirement will take effect for most Medicare Part A and B providers starting April 1, 1999. But for Medicare Part A institutional providers in Alaska, Maine, New Hampshire, New Jersey, North Carolina, Vermont, Washington and those served by fiscal intermediary Mutual of Omaha in any state, the new policy will take effect July 1, 1999.
The law requires providers and suppliers to furnish itemized statements within 30 days when requested in writing by Medicare beneficiaries. Providers should not charge beneficiaries for itemized statements, and the statements should include the beneficiary's name, the date of service, a description of the item or service furnished, the number of services provided, the provider/supplier charges, an internal reference or tracking number, and the name and telephone number of a person to contact for more information.
Beginning April 1, all Medicare carriers and intermediaries on the Fiscal Intermediary Standard System will print a statement on the Explanation of Medicare Benefits (EOMBs) and Medicare Summary Notices (MSNs) advising beneficiaries of their right to request an itemized statement from their providers. The deadline for intermediaries on the Arkansas Part A Standard System to begin printing a notice on the EOMBs and the MSNs is July 1.
Medicare contractors have been directed to inform all providers and suppliers of this new requirement. A notice to all Medicare providers and suppliers explaining the requirements of the law and including suggestions for the content of an itemized statement, has been sent to Medicare contractors and will be reprinted in forthcoming provider/supplier bulletins. HCFA has also instructed contractors to post this notice on electronic bulletin boards or web sites as soon as possible.
