Federal law prohibits all Medicare providers from billing Qualified Medicare Beneficiaries, also known as QMBs, for Medicare deductibles, coinsurance or copayments

All Medicare and Medicaid payments a provider receives for furnishing services to a qualified Medicare beneficiary are considered payment in full. These billing rules apply to BCN Advantage dual‑eligible members (those who have BCN Advantage as their primary coverage and a Medicaid product as their secondary coverage.) The Centers for Medicare & Medicaid Services language in BCN provider contracts under the “Member Hold Harmless” provision also state the provider may not hold members liable for Medicare Parts A and B cost sharing that are the legal obligation of the health plan or the state. Providers are subject to sanctions if they bill a QMB for amounts above the sum total of all BCN Advantage and Medicaid payments (even when Medicaid pays nothing).