Medicare Secondary Payer
Guidance that provides an overivew of Medicare Secondary Payer (MSP) provisions. Topics are: What is MSP, When Does Medicare Pay First (a list of situations when a beneficiary has both Medicare and other health plan coverage and which entity pays first and which entity pays second, What Happens if the Primary Payer Denies a Claim, When May Medicare Make a Conditional Payment, How Is Beneficiary Health Insurance or Coverage Information Collected and Coordinated, What Are Your Responsibilities Under the MSP Provisions, How Do You Gather Accurate MSP Data From the Beneficiary, What Happens if You Submit a Claim to Your MAC Without Adding the Other Insurer’s Information, What Happens if You Fail to File Correct and Accurate Claims, Who Do You Contact With MSP Questions, and Resources.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 01, 2020
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.