Medicare Secondary Payer Compliance: The Liability Case - Second Edition
Medicare Secondary Payer Compliance: The Liability Case - Second Edition

Author: Roy A. Franco

Publisher: Juris Publishing, Inc.

Published: 2012-12-01

Total Pages: 396

ISBN-13: 1578232732

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"[This book is a] guide and commentary for anyone involved in a liability case where the Medicare Secondary Payer Act comes into play. This book is designed to serve as a resource guide for anyone interested in learning where the potential pitfalls of the Act lay. The authors, highly versed in the complexities and nuances associated with the Act, provide commentary and analysis based on the law as it is presently known, and suggest approaches to consider when attempting to finalize the liability case. The new requirements of the Act will not be easily absorbed by the liability industry. Practices developed over decades will need to change. Extra vigilance is necessary to avoid legal liability. This book provides much needed guidance to assist the practitioner in this regard"--Provided by publisher.

Medicare Secondary Payer
Medicare Secondary Payer

Author: U.s. Government Accountability Office

Publisher:

Published: 2017-08-04

Total Pages: 48

ISBN-13: 9781974231423

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"The Centers for Medicare & Medicaid Services (CMS) is responsible for protecting Medicare's fiscal integrity. Medicare Secondary Payer (MSP) situations exist when Medicare is a secondary payer to other insurers, including non-group health plans (NGHP), which include auto or other liability insurance, no-fault insurance, and workers' compensation plans. CMS attempts to recover Medicare payments made that were the responsibility of NGHPs, but CMS has not always been aware of these MSP situations. In 2007, legislation added mandatory reporting requirements for NGHPs that should enable CMS to be aware of these situations. NGHPs reported concerns about the MSP process, and CMS delayed the start of mandatory reporting by NGHPs, in part because of these concerns. This report examines (1) how the initial implementation of mandatory reporting for NGHPs has affected the workload of and payments to MSP contractors, and Medicare savings, and (2) key challenges within the process for MSP situations involving NGHPs and the steps CMS is taking to address those challenges. GAO reviewed relevant MSP-related documents and data on MSP costs, workload, Medicare savings, and contractor performance. GAO also interviewed CMS officials, MSP contractor officials, and NGHP stakeholders."