Does CMS Have to Reimburse Healthcare Providers for Patient Debt Sent to Collections?

Double dippin’? Why yes, I’ll take two scoops of reimbursement from the Centers for Medicare and Medicaid Services.

At issue is whether or not healthcare providers can “be reimbursed for Medicare beneficiaries’ bad debts even after sending them to a debt collection agency.”

It comes down to the definition of “uncollectible.” Can a Medicare beneficiary’s debt be considered uncollectible if it has been referred to a collection agency? George Washington University Hospital says, “Yes, that debt should be considered uncollectible” — probably because if it were collectible, the hospital wouldn’t be sending that debt to a collection agency. So they took their “Yes” to court.

Medicare, though, sees it differently: “Because costs for services provided to Medicare patients cannot be shifted onto non-Medicare patients, providers can collect payment for beneficiaries’ bad debts from the Medicare program under certain circumstances. However, the Centers for Medicare & Medicaid Services said that bad debts sent to a collection agency are automatically presumed to be collectible, and therefore are not reimbursable from Medicare coffers.”

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