According to the Centers for Medicare & Medicaid Services (CMS), Medicare
Advantage plans, and their contracted providers, may charge members
administrative fees for missed appointments under certain circumstances.
However, if a provider charges for missed appointments, he or she must charge
the same amount for all patients (i.e., Medicare or non-Medicare).
According to the Professional Provider Agreement for
Independence-participating providers, although the provider may charge for a
missed appointment, he or she may not charge a ?surcharge,? such as an
added fee – above and beyond their member liability – for services
rendered. Such a practice creates a barrier to access to care and violates CMS
anti-discrimination regulations.
The Provider Manual for Participating Professional Providers, which
is available in the Current Publications section of Independence
NaviNet® Plan Central, is being updated to reflect this
position.
NaviNet is a registered trademark of NaviNet, Inc., an
independent company.