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The term “Medicare Secondary Payer” (MSP) refers to instances in which health related expenses must be submitted to other payers before they are sent to Medicare. Medivest provides comprehensive services to help comply with regulations set by the Centers for Medicare and Medicaid Services (CMS), the U.S. Department of Health and Human Services agency in charge of the Medicare program. These standards dictate when Medicare is the primary payer for health-related expenses and when other sources must pay first.
When MSP applies, beneficiaries must follow the reporting and other guidelines that CMS issues when there are other non-Medicare sources of payment available to cover an individual’s medical expenses. Working within these requirements is known as MSP compliance.
For example, beneficiaries may receive an award under a liability claim or from Workers’ Compensation for future medical expenses related to their injuries. They must use those funds for treatment costs before Medicare in certain circumstances, and they are required to update the Benefits Coordination & Recovery Center (BCRC) regarding the status of the claim. If they don’t, they may incur costly penalties and fines or experience a delay in their settlement distributions.
Complying with these requirements can be a challenge. They can be complex and time-consuming to navigate and have strict reporting deadlines. Plus, the landscape continues to evolve with legislative changes.
Medivest is the oldest and most experienced Medicare compliance solutions provider in the country. Our knowledgeable team includes industry veterans and compliance specialists to help attorneys and their clients meet their legal MSP obligations. We offer a full range of pre and post settlement options for effortless award administration that follows the CMS guidelines.