01/03/2023

Medicaid Crossover Payments from Medicare Billing

For months now I am not receiving Medicaid crossover payments from Medicare billing. Has anyone else having this problem. ????

Providers are not getting reimbursed for the Medicare co-insurance by Medicaid.  For some time, Medicare allowed amount exceeds the Medicaid allowable amount for the same procedure. FFS Medicaid used to reimburse the patient responsibility back in the early to mid-2000s, then would cover 20% of the coinsurance from 2010 to 2019. Since then, no payment is made on the co-insurance, and any provider participating with Medicaid will need to write off balances since the primary insurance payment exceeds the Medicaid allowable.