A/B MACs and DME MACs Actions for Workers’ Compensation Recovery

30.2 – A/B MACs and DME MACs Actions for Workers’ Compensation Recovery (Rev. 12438; Issued: 01-04-24; Effective: 02-06-24; Implementation: 02-06-24) The A/B MACs and DME MACs may pay for items or services, and subsequently learn that those services were work-related. The information indicating that a particular injury or illness occurred on the job does not necessarily mean that Medicare payments made for that injury were incorrect. In those circumstances, the A/B MACs and DME MACs will review the information it received to determine if an MSP occurrence needs to be added. If the information included an EOB showing that payment was made to the provider by the WC carrier, the A/B MACs and DME MACs initiates recovery according to their DPP process or accepts the funds sent with the Voluntary Refund or Credit Balance Report payment. Otherwise, recovery is made by the MSP Contractor.