|
2.6.2 Part B
The payment of the Medicare Part B coinsurance and deductibles for Medicaid clients who are Medicare beneficiaries is based on the following:
• If the Medicaid client is eligible for Medicaid only as a qualified Medicare beneficiary (QMB), Medicaid pays the Medicare Part B coinsurance/deductible on valid Medicare claims.
•If the Medicaid client is not a QMB, Medicaid pays the client's Part B:
•Deductible liability on valid, assigned Medicare claims.
•Coinsurance liability on valid, assigned Medicare claims that are within the amount, duration, and scope of the Medicaid program, and would be covered by Medicaid when the services are provided, if Medicare did not exist.
Medicaid payment of a client's coinsurance/deductible liabilities satisfies the Medicaid obligation to provide coverage for services that Medicaid would have paid in the absence of Medicare coverage.
|
