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October 18, 2018

Adjustments to Qualified Medicare Beneficiary (QMB) Claims Processed Under CR 9911

We are receiving calls regarding non-monetary mass adjustments we are processing, which include claims that were paid after October 2, 2017 and up to December 31, 2017. These adjustments are related to Qualified Medicare Beneficiary (QMB) claims impacted by Change Request (CR) 9911.

As a reminder and as noted in MLN Matters® article MM10494External PDF, we are issuing replacement Remittance Advices (RAs) that you may use to resubmit Medicaid QMB cost-sharing claims that failed to pay when QMB was initially introduced due to CR 9911.

Please refer to MLN Matters® article MM10494External PDF for additional information.

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