Backdating medicare forms

A person who would have been eligible as a QMB in the backdate period cannot receive backdated SLMB benefits.Example: Henry Schoolcraft applied for QMB on June 15, 1996. His income for June 1996 was under the QMB limit (100% of the federal poverty level). “I thought that I completely understood [Social Security strategies] but I sure didn’t understand the Medicare Part A/HSA complication.

Is it illegal to do this, and if so, how can I stop doing it without alienating my patients and their other physicians?

The potential trouble arises as a result of the fact that it’s possible to become enrolled in Medicare be enrolled in Medicare Part A* when you reach age 65 if at that time you are already receiving Social Security retirement benefits (or spousal or widow/widower benefits) or have been receiving Social Security disability benefits for more than 24 months.

Alternatively, if you claim Social Security benefits (including as a part of a “file and suspend” strategy) at any point after age 65, you’ll automatically be enrolled in Medicare Part A at that time.

PQRS was replaced by the Merit-based incentive Payment System (MIPS) under the new Quality Payment Program.

The final data submission period for reporting 2016 PQRS quality data to avoid the 2018 PQRS downward payment adjustment was January through March 2017.

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