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
Sample 1Sample 2Sample 3
Medicare Secondary Payer. MSP”)” means those provisions of the Social Security Act set forth in 42
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Examples of Medicare Secondary Payer in a sentence

  • 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.

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

  • Group shall provide timely and accurate eligibility information, including Medicare status, and identify all persons subject to the Medicare Secondary Payer statutes and regulations.

  • The information collected will be used to identify and recover past conditional and mistaken Medicare primary payments and to prevent Medicare from making mistaken payments in the future for those Medicare Secondary Payer situations that continue to exist.

  • A series of federal laws collectively referred to as the ``Medicare Secondary Payer'' (MSP) laws regulate the manner in which certain employers may offer group health care coverage to Medicare eligible employees, spouses, and in some cases, dependent children.

  • 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.

  • I agree to establish and implement proper safeguards against unauthorized use and disclosure of the data exchanged for the purposes of complying with the Medicare Secondary Payer Mandatory Reporting Provisions in Section 111 of the Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007.

  • Eligibility/benefit questions about Medicare Advantage (MA), Part D, and Medicare Secondary Payer (MSP) should be directed to the appropriate plan(s) identified in the 271 response.

  • These announcements will also be posted to the NGHP What’s New page.The Section 111 Resource Mailbox, at PL110-173SEC111-comments@cms.hhs.gov, is a vehicle that Responsible Reporting Entities (RREs) may use to send CMS policy-related questions regarding the Medicare Secondary Payer (MSP) reporting requirements included in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007.

  • 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.


More Definitions of Medicare Secondary Payer

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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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.
Sample 1
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

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.

  • 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.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Healthcare services means any services included in the furnishing to any individual of medical, podiatric, or dental care, or hospitalization, or incident to the furnishing of that care or hospitalization, and the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness, injury, or physical disability. Medically Necessary means medical, surgical, or other services required for the prevention, diagnosis, cure, or treatment of a health-related condition, including such services necessary to prevent a decremental change in either medical or mental health status. Originating Site means a site at which a patient is located at the time Healthcare Services are provided to them by means of telemedicine, which can be include a patient's home where Medically Necessary and Clinically Appropriate. Store-and-forward Technology means the technology used to enable the transmission of a patient's medical information from an Originating Site to the Healthcare Provider at the Distant Site without the patient being present. Telemedicine means the delivery of clinical Healthcare Services by use of real time, two-way synchronous audio, video, telephone-audio-only communications or electronic media or other telecommunications technology including, but not limited to: online adaptive interviews, remote patient monitoring devices, audiovisual communications, including the application of secure video conferencing and store-and-forward technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, counseling and prescribing treatment, and care management of a patient’s health care while such patient is at an Originating Site and the Healthcare Provider is at a Distant Site, consistent with applicable federal laws and regulations. “Telemedicine” does not include an email message or facsimile transmission between a Provider and patient, or an automated computer program used to diagnose and/or treat ocular or refractive conditions. General Requirements

  • Child care provider means a provider who receives compensation for providing child care services on a regular basis, including an ‘eligible child care provider’ (as defined in section 658P of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n)).

  • Extended foster care services means residential and other

  • Family child care home means a private home in which 1 but fewer than 7 minor children are received for care and supervision for compensation for periods of less than 24 hours a day, unattended by a parent or legal guardian, except children related to an adult member of the household by blood, marriage, or adoption. Family child care home includes a home in which care is given to an unrelated minor child for more than 4 weeks during a calendar year. A family child care home does not include an individual providing babysitting services for another individual. As used in this subparagraph, "providing babysitting services" means caring for a child on behalf of the child's parent or guardian if the annual compensation for providing those services does not equal or exceed $600.00 or an amount that would according to the internal revenue code of 1986 obligate the child's parent or guardian to provide a form 1099-MISC to the individual for compensation paid during the calendar year for those services.