No-Interest Charges on Medicare Accounts

June 1, 2008

I have searched online articles and appropriate Web sites, including CMS, but have been unable to find a definitive answer to this question: Is it legal to charge interest on an outstanding balance in a Medicare beneficiary’s account? I have been told that charging interest on an outstanding balance violates the conditions of participation because a provider then ends up charging more than allowed by Medicare. Could you please clarify?

Question: I have searched online articles and appropriate Web sites, including CMS, but have been unable to find a definitive answer to this question:

Is it legal to charge interest on an outstanding balance in a Medicare beneficiary’s account? I have been told that charging interest on an outstanding balance violates the conditions of participation because a provider then ends up charging more than allowed by Medicare. Could you please clarify?

Answer: That is right.

And it is stated right in the first paragraph of the Medicare participating physician agreement: “For purposes of this agreement, accepting assignment of the Medicare Part B payment means requesting direct Part B payment from the Medicare program. Under an assignment, the approved charge, determined by the Medicare carrier, shall be the full charge for the service covered under Part B. The participant shall not collect from the beneficiary or other person or organization for covered services more than the applicable deductible and coinsurance.”