Medicare Secondary Payer definition

Medicare Secondary Payer or (MSP) means the Medicare COB requirements as incorporated in Medicare Advantage (MA) regulations.
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Medicare Secondary Payer. MSP”)” means those provisions of the Social Security Act set forth in 42
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Medicare Secondary Payer. “MSP”)” means those provisions of the Social Security Act set forth in 42 U.S.C. §1395 y (b), and the implementing regulations set forth in 42 C.F.R. Part 411, as amended, which regulate the manner in which certain employers may offer group health care coverage to Medicare–eligible employees, their spouses and, in some cases, dependent children. (See Exhibit 3 Section 6 titled “Medicare Secondary Payer Information Reporting.”)
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Examples of Medicare Secondary Payer in a sentence

  • When the Member is eligible for Medicare due to age, if the subscriber is actively working for a group that employs 20 or more employees (as defined by Medicare Secondary Payer laws).

  • When the Member is eligible for Medicare due to age, if the subscriber is actively working for a group that employs less than 20 employees (as defined by Medicare Secondary Payer laws).

  • When the Member is eligible for Medi- care due to disability, if the subscriber is covered by a group that employs 100 or more employees (as defined by Medicare Secondary Payer laws).

  • Domestic PartnersUnder federal law, the Medicare Secondary Payer Rules do not apply to Domestic Partners covered under a group health plan when Medicare coverage is due to age.

  • When the Member is eligible for Medi- care due to age, if the subscriber is ac- tively working for a group that employs 20 or more employees (as defined by Medicare Secondary Payer laws).

  • When you are eligible for Medicare due to disability, if the Participant is covered by a group that employs less than 100 employ- ees (as defined by Medicare Secondary Payer laws).

  • When the Member is eligible for Medicare due to disability, if the subscriber is covered by a group that employs 100 or more employees (as defined by Medicare Secondary Payer laws).

  • They apply in situations where the federal Medicare Secondary Payer Program allows Medicare to be the primary payer of a Covered Person's medical care claims.

  • It is the intent of the Plan to abide by the Medicare Secondary Payer Rules.

  • There are many federal regulations regarding Medicare Secondary Payer provisions, and other coverage may not be subject to those provisions.Child — For a Child whose parents are not separated or divorced, the coverage of the parent whose birthday falls earlier in the Calendar Year pays first.


More Definitions of Medicare Secondary Payer

Medicare Secondary Payer means a series of statutory provisions that require other payers (e.g., group health plans, liability and no-fault insurers, and entities that are self-insured) to pay for medical items and services before Medicare pays, when certain specific conditions are satisfied. Under certain circumstances, Medicare may also make a conditional payment. Such a payment is conditioned on reimbursing the Medicare program once another payer makes payment.
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Medicare Secondary Payer or “MSP” means those provisions of the Social Security Act set forth in 42 U.S.C. §1395 y (b), and the implementing regulations set forth in 42 C.F.R. Part 411, as amended, which regulate the manner in which certain employers may offer group health care cover- age to Medicare-eligible employees, their spouses and, in some cases, dependent children.
Sample 1
Medicare Secondary Payer. MSP”)” means those provisions of the Social Security Act set forth in 42 U.S.C. w1395 y (b), and the implementing regulations set forth in 42 C.F.R. Part 411, as amended, which regulate the manner in which certain employers may offer group health care coverage to Medicare-eligible employees, their spouses and, in some cases, dependent children. (See Section 18 of this Exhibit titled “MEDICARE SECONDARY PAYER (“MSP”) DATA MATCH.”)
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Related to Medicare Secondary Payer

  • Health care services means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.

  • Home health care services means medical and nonmedical services, provided to ill, disabled or infirm persons in their residences. Such services may include homemaker services, assistance with activities of daily living and respite care services.

  • Primary care services means the services in respect of which NHS England has a duty or power to make arrangements pursuant to the Primary Care Functions;

  • Health care provider or "provider" means:

  • Qualified long-term care services means services that meet the requirements of Section 7702(c)(1) of the Internal Revenue Code of 1986, as amended, as follows: necessary diagnostic, preventive, therapeutic, curative, treatment, mitigation and rehabilitative services, and maintenance or personal care services which are required by a chronically ill individual, and are provided pursuant to a plan of care prescribed by a licensed health care practitioner.

  • Healthcare services means services or goods provided for