Medicare Secondary Payer Manual (Pub. 100-05), Ch. 7 § 20.10

Courtesy Copy of All MSP GHP-Based Recovery Correspondence to the

Last amended: 2024Year: 2024Length: 269 wordsOfficial source
20.10 – Courtesy Copy of All MSP GHP-Based Recovery Correspondence to the Insurer/Third Party Administrator (TPA) (Rev. 12438; Issued: 01-04-24; Effective: 02-06-24; Implementation: 02-06-24) MSP Contractors currently initiate GHP-based recoveries of mistaken payments to the employer/ other plan sponsor (considered the debtor if it received the original demand), with the exception of federal employers. In order to facilitate employer/ other plan sponsor’s efforts in responding to demand packages, MSP Contractors shall send a copy of these demand packages and all other recovery correspondence to the employer/ other plan sponsor’s insurer/TPA. The courtesy copy sent to the employer/ other plan sponsor’s insurer/TPA does not change the employer/ other plan sponsor’s status as the debtor. The insurer/TPA is not considered a debtor because the insurer/TPA was not the addressee on the original demand letter. For Federal employer/ other plan sponsors, the insurer is considered the debtor and the demand letter is addressed to the insurer. MSP Contractors shall comply with the sending of the courtesy copy of the demand package(s) to the employer/ other plan sponsor’s insurer/TPA. The demand letter will be addressed to the employer/ other plan sponsor, and the employer/ other plan sponsor is considered to be the debtor. MSP Contractors shall follow debt referral procedures in § 70 of this chapter. The fact that the insurer/TPA receives a copy of the demand package or that the insurer/TPA may be given authority to resolve a debt on behalf of its client (the employer/ other plan sponsor) does not change the status of the employer/ other plan sponsor as the debtor and as the entity to be referred to Treasury.
Medicare Secondary Payer Manual (Pub. 100-05), Ch. 7 § 20.10: Courtesy Copy of All MSP GHP-Based Recovery Correspondence to the | Justis AI