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Solving the MSP Dilemma: A Strategy for Health Care Providers to Avoid Exposure Under the Medicare Secondary Payer Statute

First few Article Sentences

The Medicare Secondary Payer (“MSP”) statute was originally enacted by Congress in 1980 to reduce federal health care costs. (42 U.S.C. § 1395y(b).) This cost saving is accomplished by making Medicare a secondary payer, with the primary payer being any third party insurance company or self-insured business subsequently found liable for a Medicare beneficiary’s medical costs. Under the MSP statute, if Medicare pays a beneficiary’s medical bills, those payments are deemed conditional and the Centers for Medicare & Medicaid Services (“CMS”) can seek reimbursement from a primary payer and/or the recipient of a primary payment. This article examines the potential risk the MSP statute poses for a health care provider settling a personal injury or wrongful death action, and suggests a solution that allows providers to avoid that risk.

Cohn, Jonathon, E.

Phillips, Jonathan E.

Arent Fox LLP

Law, Provider Reimbursement

June 3, 2011

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