According to the Centers for Medicare & Medicaid Services (CMS), Medicare Advantage plans, and their contracted providers, may charge members administrative fees for missed appointments under certain circumstances. However, if a provider charges for missed appointments, he or she must charge the same amount for all patients (i.e., Medicare or non-Medicare).

According to the Professional Provider Agreement for AmeriHealth-participating providers, although the provider may charge for a missed appointment, he or she may not charge a ?surcharge,? such as an added fee – above and beyond their member liability – for services rendered. Such a practice creates a barrier to access to care and violates CMS anti-discrimination regulations.

The Provider Manual for Participating Professional Providers, which is available in the Current Publications section of AmeriHealth NaviNet^® Plan Central, is being updated to reflect this position.

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