Medicare Secondary Payer (MSP) is the term generally used when the Medicare program does not have primary payment responsibility – that is, when another entity has the responsibility for paying before Medicare. When Medicare began in 1966, it was the primary payer for all claims except for those covered by Workers’ Compensation, Federal Black Lung benefits, and Veteran’s Administration (VA) benefits.
In 1980, Congress passed legislation that made Medicare the secondary payer to certain primary plans in an effort to shift costs from Medicare to the appropriate private sources of payment. The MSP provisions have protected Medicare Trust Funds by ensuring that Medicare does not pay for items and services that certain health insurance or coverage is primarily responsible for paying. The MSP provisions apply to situations when Medicare is not the beneficiary’s primary health insurance coverage. Medicare statute and regulations require that all entities that bill Medicare for items or services rendered to Medicare beneficiaries must determine whether Medicare is the primary payer for those items or services.
Primary payers are those that have the primary responsibility for paying a claim. Medicare remains the primary payer for beneficiaries who are not covered by other types of health insurance or coverage. Medicare is also the primary payer in certain instances, provided several conditions are met.
A pregnancy test measures a hormone in the body called human chorionic gonadotropin (HCG). [...]
The periosteum is a fibrous sheath that covers bones. It contains the blood vessels and nerves [...]
Asthma - child - discharge
Your child has asthma, which causes the airways of the lungs to swell and narrow. In the... [...]
IRMC Partners in Education with Indian River County Sheriff’s Office and the Indian River County School District
Vero Beach, FLA (August 8, 2017) — First responders gain valuable education in preventing [...]
IRMC COO Announces Resignation
Camie Patterson Vero Beach, FLA (Aug. 3, 2017) — Indian River Medical Center (IRMC) announced the [...]
Indian River Medical Center Earns ACR Computed Tomography Accreditation
Pictured: Jeanrick Francois, ARRT (R)(CT), Amber Nusser, ARRT (R)(CT), and Daiana Miller, ARRT [...]