GHP Pays Portion of Charges

40.4.2 - GHP Pays Portion of Charges (Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22) Medicare secondary payment can be made if the following conditions are met: • A GHP pays an amount less than the physician's/supplier's charges for the services, and less than the gross amount payable by Medicare (as defined below), and; • the provider does not accept, and is not obligated to accept, the payment as payment in full. “Payment in full” is an amount that the provider is obligated to accept (e.g., contractually) or voluntarily accepts as payment in full from the insurer (i.e., the GHP) in full satisfaction of the patient’s payment obligation. Because Medicare payments are made on behalf of the beneficiary, satisfaction of a patient’s payment obligation satisfies any Medicare payment obligation.”