Hello all,

CMS has asked about problems with QMBs getting protection from co-pays for Part B drugs at retail pharmacies and what seemed to be the sticking points. There have been a couple of cases in California where the pharmacy staff wanted to do the right thing but insisted that they were absolutely required to charge what the computer said.  Have you run into this or other QMB billing scenarios for Part B in the last couple of years? CMS is trying to get a handle on typical ways the problem presents itself both in the fee for service and MA-PD contexts.  Any stories to tell, including ones where you ultimately got a good resolution?

 

Thanks,

Leslie

 

Leslie Fried, JD

Senior Director, Center for Benefits Access

Office: 571.527.3992

xxxxxx@ncoa.org

 

National Council on Aging

Improving the lives of millions of older adults

251 18th Street South, Suite 500

Arlington, VA 22202

ncoa.org | @NCOAging

 

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