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The rules that decide whether Medicare is the primary payer or secondary payer are complex. Individuals with two types of health insurance may benefit from comprehensive coverage.
Medicare usually covers most of your healthcare costs, but if you have other insurance coverage, it can act as a secondary payer for some of the costs.
HRAs must follow "a variety of statutory rules and provisions" including the COBRA continuation coverage requirements, ERISA, and HIPAA. [16] HRA plans are considered "Primary Payers" subject to Medicare Secondary Payer (MSP) mandatory reporting requirements. There are significant penalties for failure to comply with the MSP reporting requirements.
The Medicare Secondary Payer provision of the ESRD program (also known as the ESRD Coordination Period) was enacted as part of the Omnibus Budget Reconciliation Act of 1981. MSP provides for a coordination of benefits period between Medicare and private health insurance plans for individuals entitled to Medicare solely on the basis of ESRD.
In 2000, CMS changed the reimbursement system for outpatient care at Federally Qualified Health Centers (FQHCs) to include a prospective payment system for Medicaid and Medicare. [2] Under this system, health centers receive a fixed, per-visit payment for any visit by a patient with Medicaid, regardless of the length or intensity of the visit.
In that case, Medicare is secondary, meaning a person could delay enrollment in Part B. Employer-based insurance is secondary if it is provided by an employer with fewer than 20 employees.
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