On October 31, the CFPB and Centers for Medicare & Medicaid Services issued a joint statement reminding Medicare providers, Medicare Advantage plans, and debt collectors of their responsibilities under federal law to protect Qualified Medicare Beneficiaries (QMBs). QMBs are low-income older adults and people with disabilities whose Medicare premiums and Medicare Parts A and B cost-sharing are covered by state Medicaid agencies. The statement noted that although Federal law prohibits billing QMBs for such cost-sharing, some providers continue to do so improperly.

The agencies highlighted that approximately 9 percent of QMBs reported problems with paying medical bills compared to 6 percent of other Medicare beneficiaries. They stressed the importance of QMB billing prohibitions and noted that QMBs often struggle to receive refunds from improperly collected amounts, may experience distress when unpaid bills are referred to collection agencies, and may avoid seeking healthcare due to fear of improper billing.

To reinforce relevant protections, CMS released the following guidance:

• A fact sheet reminding healthcare providers that billing QMBs is prohibited and that any improperly collected amounts must be refunded.
• An updated health plan management system memo detailing plan responsibilities for accurately communicating QMB status to network providers, including pharmacies, and advising them of their responsibility to repay any amounts improperly collected from QMBs.

The CFPB also emphasized that the FDCPA prohibits false or misleading debt collection practices, including misrepresenting debts owed by QMBs and noted that debt collectors can be held strictly liable for such violations — even if they are relying on inaccurate information provided by healthcare providers or insurance companies. Additionally, the CFPB cited the FCRA as prohibiting persons from furnishing inaccurate information to consumer reporting agencies, including misrepresentations about amounts owed by QMBs, and requiring furnishers of information to verify the accuracy of information furnished and to establish accurate information policies.

The agencies urged all relevant parties to comply with these laws to protect QMBs from improper billing and debt collection practices.