Prohibition Against Waiver of Health Insurance Benefits as a

10.2 - Prohibition Against Waiver of Health Insurance Benefits as a Condition of Admission (Rev. 3441, Issued: 01-15-16, Effective; 12-31-13; ASC X12: 01-01-12, MAC Implementation: 02-16-16; ASC X12: 02-16-16) Providers may not require, as a condition of admission or treatment, that a patient agree to waive the right to have services paid for under Medicare. Requiring such a “waiver” is inconsistent with the agreement with CMS, and the “waiver” is not binding upon the patient. Providers have agreed not to charge an individual (except for specified deductible and coinsurance amounts) for services for which such individual is entitled to have payment made or for which he/she would be entitled if the provider complied with the procedural and other requirements of the program. Further, under this provision, the provider must refund any amounts incorrectly collected. Where a patient who has signed such a waiver, nevertheless, requests payment under the program, the provider must bill the A/B MAC (A) and refund any payments made by the patient, or on the patient’s behalf, in excess of permissible charges.