• E-mail
• Print
• RSS

News: GAO report says Medicare is not appropriately recovering MSP debt

Patient Financial Services Weekly Advisor, September 24, 2004

Medicare contractors in 2003 collected just 38 cents for every dollar the program spent to recover payments incorrectly made for patients who have other health insurance, the Government Accountability Office said in a September 20 report.

Medicare is considered the secondary payer for beneficiaries with other health insurance, such as employer-sponsored group health plans (EGHP) or worker's compensation.

CMS estimated that about 8% of Medicare beneficiaries in fiscal year 2000 had claims that appeared to be the primary responsibility of another insurer.

Because Medicare does not always know whether a beneficiary has other primary insurance, it may unintentionally pay for services that are subsequently determined to be the financial responsibility of another payer, the report said. These mistaken payments-Medicare Secondary Payer (MSP) debt-represent money owed to Medicare.

The report noted that CMS is developing a new recovery system-ReMAS-to enhance the MSP recovery process. Pilot testing of ReMAS on EGHP cases is set to begin in October.

To read the highlights, click here.

To read the full report, click here.

• E-mail to a Colleague
• Print
• RSS
• Archive