Attention: All Providers Reprocessing of QMB Claims

As previously communicated in a May 2016 Medicaid Special Bulletin, Medicaid is legally obligated to reimburse providers for cost sharing that is due for Qualified Medicare Beneficiaries (QMBs) according to the state’s CMS-approved Medicare cost-sharing payment methodology.

DMA will begin the reprocessing of QMB claims beginning with the June 21 checkwrite.

 

Refer to the May 2016 Special Bulletin, NCTracks Updates: Claims Reprocessing of Crossover Claims for Services Rendered to Qualified Medicaid Beneficiaries (QMB), for additional details on the reprocessing.