WASHINGTON, D.C. — The Consumer Financial Protection Bureau (CFPB) and the Centers for Medicare & Medicaid Services (CMS) have issued a joint statement to address unlawful medical billing practices. This initiative targets the protection of individuals in the Qualified Medicare Beneficiary (QMB) group, who comprise approximately one in eight Medicare recipients nationwide and are legally shielded from cost-sharing charges like co-pays and deductibles.
The joint statement underscores the legal prohibition against billing QMBs for any costs beyond those covered by Medicare. “Medical bills are a major contributor to bankruptcy and financial collapse for a family,” stated CFPB Director Rohit Chopra. The statement further highlights the ongoing efforts by the Biden-Harris Administration to enhance healthcare affordability and accessibility, as emphasized by CMS Administrator Chiquita Brooks-LaSure, who noted that “No one should go bankrupt from getting the health care they need.”
Healthcare providers, suppliers, and debt collectors are reminded that non-compliance with these regulations could result in sanctions by CMS or legal liabilities under federal law. New resources from CMS clarify that providers must refund any improper charges, even when such errors stem from incorrect information about a recipient’s QMB status.
Despite existing protections, improper billing remains a prevalent issue affecting millions of vulnerable Americans. In 2021, approximately 8.7 million individuals were enrolled in the QMB group, yet instances of improper billing persist, exacerbated by inaccuracies from Medicare Advantage plans. Such errors can lead to unwarranted debt collection actions and tarnished credit reports, which in turn impact beneficiaries’ access to essential services like housing and utilities.
The CFPB has received numerous complaints highlighting these issues, with around 17% of all Medicare-related grievances referencing improper debt collection attempts against QMBs. The statement clarifies that under the Fair Debt Collection Practices Act, debt collectors are prohibited from pursuing debts that are not owed. Additionally, inaccurate billing information on credit reports may violate the Fair Credit Reporting Act.
The CFPB and CMS’s recent actions build on a broader effort by the Biden-Harris Administration to mitigate the burden of medical debt. This includes issuing guidance to curb illegal debt collection practices and proposing regulations to exclude medical debts from credit reports. The agencies reaffirm their commitment to enforcing these protections, ensuring that debt collectors who infringe upon patient rights face appropriate consequences.
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