Medicare program; Medicare secondary payment--HCFA. General notice

This notice provides guidelines for complying with 42 CFR 411.25, which provides that certain third party payers for health services furnished to Medicare beneficiaries must furnish certain information to Medicare intermediaries and carriers when they learn that Medicare made primary payment for services for which the third party payer has made or should have made primary payment. The notice also informs third party payers that they should contact HCFA if they wish to discuss arrangements for exchanging, on a voluntary basis, data about beneficiaries for whom the third party payer has a primary payment obligation under the Medicare Secondary Payer (MSP) provisions of the Medicare law. The third party payers affected by this notice are workers' compensation plans and insurers; all liability and no-fault insurers, including automobile insurers; and group health plans under certain circumstances, including plans which are self-insured and/or self-administered. If the group health plan, or workers' compensation plan is self-insured and self-administered, the employer must provide the notice; otherwise the insurer, underwriter or third party administrator must give the notice. This description of information third party payers must furnish is intended to help ensure that, in accordance with the Medicare law, Medicare pays only secondary to primary coverage of third party payers.