Medicare Remittance Advice for Qualified Medicare Beneficiary Claims processing issue

CMS has identified an issue with the implementation of Change Request (CR) 9911 which modified the Medicare Remittance Advice (RA) for Qualified Medicare Beneficiary (QMB) claims to indicate the QMB status of patients and reflect zero cost-sharing liability. These beneficiaries are covered by both Medicare and Medicaid. On October 2, 2017 Change Request 9911 modified the Medicare Remittance Advice (RA) for Qualified Medicare Beneficiary (QMB) claims to identify QMB patients and reflect zero cost-sharing liability. This change resulted in unanticipated issues for providers, states, and other secondary payers who are used to seeing Medicare deductible and coinsurance amounts in specific fields on the RA. Beginning December 8, 2017 CMS systems will revert back to the previous display of patient responsibility for QMBs on RAs. Providers may want to hold QMB claims and submit them after December 8.