Medicare Secondary Payer Manual (Pub. 100-05), Ch. 5 § 40.3.3

GHP Gives Medicare Beneficiary Choice of Using Preferred Provider

Last amended: 2022Year: 2022Length: 82 wordsOfficial source
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.
Medicare Secondary Payer Manual (Pub. 100-05), Ch. 5 § 40.3.3: GHP Gives Medicare Beneficiary Choice of Using Preferred Provider | Justis AI