Participation in Medicare Clause Samples
The Participation in Medicare clause establishes the requirement for a healthcare provider or entity to be enrolled and in good standing with the Medicare program. This typically means the provider must meet all federal standards, maintain necessary certifications, and comply with Medicare billing and reporting requirements. By including this clause, contracts ensure that services rendered are eligible for Medicare reimbursement and that the provider is authorized to treat Medicare beneficiaries, thereby reducing the risk of non-payment and regulatory non-compliance.
Participation in Medicare. All employees who retire from District service and become Medicare-eligible (currently age 65) are required to enroll in a Medicare-coordinated plan. Failure to enroll in a Medicare-coordinated plan after receiving 30 days’ notice from the District of this requirement shall result in termination of health benefits All persons who receive health benefits from the District must provide evidence to the District that they have successfully enrolled in Medicare Part A or present documentation why they are not eligible to enroll. For retirees enrolled in District benefits the District will reimburse Medicare Part B for those retiring with Medicare Part A. . Retirees may request reimbursement for the previous calendar year. Annually, in February, District will send a letter to retirees soliciting appropriate paperwork and documentation to be reimbursed for Medicare
Participation in Medicare. All retirees from the bargaining unit who receive health benefits from the District must provide evidence to the District that they have successfully enrolled in Medicare Part A or present documentation why they are not eligible to enroll. The District will reimburse Medicare Part B for those retiring with Medicare Part A. For retirees enrolled in District benefits, to be eligible for reimbursement for Medicare B, retirees must participate in a District-sponsored Medicare Coordinated/Advantage program for the period in which reimbursement is sought. Retirees may request reimbursement for the previous calendar year. Annually, in February, District will send a letter to retirees soliciting appropriate paperwork and documentation to be reimbursed for Medicare
Participation in Medicare. All retirees from the bargaining unit who receive health benefits from the District must provide evidence to the District that they have successfully enrolled in Medicare Part A or present documentation why they are not eligible to enroll. The retiree must enroll in Medicare Part B and the District will pay Medicare Part B for those retiring with Medicare Part A.