Medicare Secondary Payer Rules Effective for Group Health Plans

The Medicare Secondary Payer (MSP) rules went into effect January 1, 2009, and ASR Health Benefits is in full compliance with this legislation as the responsible reporting entity (RRE) for the group health plans it administers.
    
The Centers for Medicare & Medicaid Services (CMS) is collecting various data elements from applicable reporting entities to implement mandatory MSP reporting requirements.  These requirements are part of Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007.  The information CMS collects will be used to ensure that Medicare makes payment in the proper order or takes necessary recovery actions.  MSP refers to those situations where Medicare does not have primary responsibility for paying the medical expenses of a Medicare beneficiary.

Third-party administrators of group health plans, such as ASR Health Benefits, will be required to gather information from plan sponsors and plan participants to help CMS identify situations in which the group health plans are, or have been, primary to Medicare.  Once data have been submitted, CMS will use the information to ensure that payment is made in the proper order and to pursue recovery activities.

The RRE must report certain data elements to CMS, including social security numbers (SSNs) of employees and their dependents.  Consequently, ASR Health Benefits will be contacting employers to collect the SSNs of all dependents of employees that we currently do not have on record, as required by the MSP rules.  If you have questions about the MSP rules, please contact ASR Health Benefits at (616) 957-1751 or (800) 968-2449 and ask for Maggie Tueth.