Medicare Secondary Payer Manual (Pub. 100-05), Ch. 1 § 20.6
Liability Insurance
20.6 - Liability Insurance
(Rev.11755, Issued:12-21-22, Effective: 01-23-23, Implementation: 01-23-23)
Medicare is secondary to any liability insurance (e.g., automobile liability insurance and
malpractice insurance), pursuant to 42 CFR § 411.50. (See Pub. 100-05, Chapter 2, §40.)
(See Pub. 100-05, Chapter 2, §40.) Liability insurance means insurance (including a self-
insurance plan) that provides payment based on the policyholder’s alleged legal liability
for injury or illness or damage to property. It includes, but is not limited to, homeowners'
liability insurance, malpractice insurance, product liability insurance, and general
casualty insurance. It includes payments under state "wrongful death" statutes that
provide payment for medical damages. An entity that engages in a business, trade, or
profession is considered to be self-insured for liability purposes to the extent that it has not
purchased liability insurance.