Billing Members for Covered Services Sample Clauses

Billing Members for Covered Services. The Contractor and its Providers and Subcontractors shall not xxxx a Member for Medically Necessary Covered Services with the exception of applicable co-pays or other cost sharing requirements provided under this Contract. Any Provider who knowingly and willfully bills a Member for a Medicaid Covered Service shall be guilty of a felony and upon conviction shall be fined, imprisoned, or both, as defined in Xxxxxxx 0000X(x)(0) 00 X.X.X. 0000x-0x of the Social Security Act. This provision shall remain in effect even if the Contractor becomes insolvent. However, if a Member agrees in advance in writing to pay for a Non-Medicaid covered service, then the Contractor, the Contractor’s Provider, or Contractor’s Subcontractor may xxxx the Member. The standard release form signed by the Member at the time of services does not relieve the Contractor, Providers and Subcontractors from the prohibition against billing a Medicaid Member in the absence of a knowing assumption of liability for a Non-Medicaid Covered Service. The form or other type of acknowledgement relevant to Medicaid Member liability must specifically state the services or procedures that are not covered by Medicaid.
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Related to Billing Members for Covered Services

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