CWF MSP Reject for A Beneficiary Entitled to Medicare Part B

40.9 - CWF MSP Reject for A Beneficiary Entitled to Medicare Part B Only and A GHP (Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23) An MSP situation cannot exist when a beneficiary has GHP coverage (i.e., working aged, disability and ESRD) and is entitled to Part B only. CWF will edit to prevent the posting of these MSP records to CWF when there is no Part A entitlement date. Currently, if a contractor submits an ECRS transaction to the MSP Contractor to add a GHP MSP record where there is no Part A entitlement, the A/B MAC and DME MAC will receive a reason code of 61, MSP cannot exist without Part A entitlement. A/B MACs and DME MACs shall not submit an ECRS request to the MSP Contractor to establish a GHP MSP record when there is no Part A entitlement. A/B MACs and DME MACs that attempt to establish an “I” record will receive a CWF error. The CWF shall continue to allow the posting of Part B MSP records where there is no Part A entitlement when NGHP situations exists, such as automobile, liability, and workers’ compensation. Where an NGHP situation exists, the A/B MAC and DME MAC shall continue to submit ECRS transactions and establish “I” records, as necessary.