CMS Pub. 100-04, ch. 1, § 10.1.6

B3-3103

Carrier jurisdiction claims for individuals who are QRRBs, including those who are

entitled to both social security and railroad retirement benefits, are handled by the

Palmetto Government Benefits Administrators (GBA) LLC, a subsidiary of Blue Cross

and Blue Shield of South Carolina, with the following exceptions:

• The services are furnished by a M+C organization which deals directly with CMS

on a cost basis;

• The QRRB is enrolled under a buy-in agreement involving a State agency that has

entered into an agreement to act as a carrier with respect to such individuals; or;

• The medical services were provided outside the United States, in which case the

RRB handles the claim. (See §10.1.4.6 for handling claims for services in

Mexico.)

If a claim involves medical services provided both within and outside the United States,

Palmetto GBA processes the claim for the medical services provided within the United

States. If the claimant raises a question as to why the medical services provided outside

the United States were not paid, Palmetto GBA directs the claimant to contact the RRB

and forwards the claims to them at:

Railroad Retirement Board

Division of Disability and Health Insurance

844 Rush St.

Chicago, IL 60611