44-3612. Durable medical equipment, prosthetic, orthotic, or supply; billing; beneficiary; agreement.
136 words·~1 min read·
/ne/chapter-44/44-3612A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
A supplier that is a nonparticipating provider in the medicare program shall not balance bill a Nebraska medicare beneficiary for any durable medical equipment, prosthetic, orthotic, or supply for which the supplier has not accepted assignment, unless the beneficiary
(1)agrees in writing prior to such billing to pay the additional amount and
(2)pays the full amount prior to receipt of the durable medical equipment, prosthetic, orthotic, or supply. Such agreement shall provide notification to the beneficiary that medicare reimburses eighty percent of the medicare-approved amount and that an issuer of a medicare supplement policy or certificate shall not be required to reimburse the supplier or the beneficiary in an amount greater than one hundred fifteen percent of the medicare-approved amount for durable medical equipment, prosthetics, orthotics, or supplies as provided in section 44-3613 .