Medicare Secondary Payer Manual (Pub. 100-05), Ch. 5 § 40.3.3
GHP Gives Medicare Beneficiary Choice of Using Preferred Provider
40.3.3 - GHP Gives Medicare Beneficiary Choice of Using Preferred Provider
(Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22)
If a Medicare beneficiary is given the choice by the GHP whether to choose a preferred provider or to
obtain medical services from a non-preferred provider, the beneficiary may choose the non-preferred
provider and Medicare makes secondary payments based on the amount paid by the GHP. However,
see Chapter 1 of Pub. 100-05 for rules governing employer-sponsored HMO/CMPs when Medicare
cannot make primary payments.