Medicare Secondary Payer Task Force
Most self-insured entities, liability insurers and other primary payers understand that there are mandatory reporting obligations under Section 111 of the Medicare, Medicaid and S-CHIP Extension Act (MMSEA) and have been reminded about the long-standing obligation to reimburse Medicare under the Medicare Secondary Payer Act (MSP). Many are still uncertain, however, what these obligations are, what the penalties for failure to comply include, and how these laws impact claims and litigation involving claimants who may be Medicare beneficiaries. The SMART Act amends the MSP Act with respect to Section 111 reporting as well as conditional payment reimbursement and regulations operationalizing the SMART Act will be promulgated fully at a later date. In short, the MSP Act is a work in progress and our clients need to be aware of the most recent changes in real time.
To that end, the DRI MSP Task Force has assembled materials to assist you and your clients in making your way toward understanding these, at times confusing, laws and requirements. You will find background information and materials to teach you about the history and intent of the legislation. You will find links to the laws and regulations themselves as well as official government websites that provide additional information and materials. We have also established a listserve accessible through the DRI website to allow for the exchange of information and ideas as we all learn the best way to comply with these obligations, and we are working on a Best Practices Guide for your reference. Finally, we continue to compile a library of MSP caselaw, housing in the MSP Opinion Tracker. Our goal is to make this site your comprehensive resource for all things MSP related. Please use this website as your starting point for MSP compliance.
Our goal is to make this site your comprehensive resource for all things MSP related. Please use this website as your starting point for MSP compliance. DRI also takes this opportunity to introduce you to the Medicare Advocacy Recovery Coalition (MARC) which has been collaborating and developing strategic alliances with Congressional leaders and government agencies to focus on broader MSP reform. Presently MARC has 45 active member organizations comprised of entities representing virtually every sector of interested stakeholders including attorneys, brokers, insures, insurers, insurance and trade associations, self-insureds and third-party administrators. DRI is a member.
The DRI MSP Task Force notes that this is a fast changing area of the law that requires close attention. Accordingly, the user is advised that some of the information contained in this web-page, particularly some information in earlier articles, is now out of date, and other items will become out of date as time goes on. Please make certain to use the official government links provided below to verify the current specifics of the statutes and regulations.back to top
- MSP Manual Chapter 7
- CMS MMSEA Section Reporting User Guide for NGHP
- CMS WCMSA Reference Guide
- Medicare Secondary Payer Recovery Contractor (MSPRC)
- Medicare Advocacy Recovery Coalition (MARC)
- CMS Final Rule operationalizing Section 201 of the SMART Act (Appeal Rights for Applicable Plans)
- August 19, 2014 Section 111 NGHP Alert – Liability Insurance (Including Self-Insurance): Exposure, Ingestion, and Implantation and December 5, 1980
- CMS Alert: Change in Reporting Threshold for Certain Liability Settlements, Judgements Awards, or Other Payments
- CMS Alert: Computation of Annual Liability Insurance Settlement Reporting and Recovery Threshold
- DRI Comment on CMS-6061-ANPRM; Medicare Program; Medicare Secondary Payer and Certain Civil Money Penalties
- Medicare Reimbursement in 2013
- Just Add CMS Guidance - Modernizing MSP Cost Containment Protocols
- Setting The Record Straight: Dispelling Medicare Myths in Tort Settlements
- A Rock and a Hard Place: Medicare Compliance in First-Party Claims
- DRI Formal Comments to Centers for Medicare and Medicaid Services on Proposed Rulemaking
- Medicare Secondary Payer and "Future Medicals"
- The Third Circuit Finds Medicare Advantage Plans Afforded the Same Right of Private Action as Medicare under the Medicare Secondary Payer Act
- MSP and “Future Medicals” A Movement Toward a Standardized Process?
- MSPRC Announces $300 Threshold for Liability Settlements
- Municipalities and Medicare
- Resolution of a Case with a Medicare Claimant?
- The Revised Medicare Secondary Payer Act
- The Next Chapter in Medicare Compliance
Garretson Resolution Group
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