Medicare Secondary Payer Manual (Pub. 100-05), Ch. 7 § 70.8

Validation of Possible Eligible Debts for Referral

Last amended: 2024Year: 2024Length: 258 wordsOfficial source
70.8 – Validation of Possible Eligible Debts for Referral (Rev. 12438; Issued: 01-04-24; Effective: 02-06-24; Implementation: 02-06-24) MSP Contractors are reminded that if one or more of the claims in a specific debt were covered by a MSP GHP settlement, those claims released in the settlement may not be included in the ITR letter and must be handled appropriately. NOTE: MSP Contractors shall follow all CMS communications specific to litigation or negotiation activities as conveyed by CMS and ensure compliance with all instructions. For Non-GHP debts; MSP Contractors shall confirm notice of settlement, judgment, award or other payment had been received on a liability, no fault or workers’ compensation case and a recovery demand letter was issued. For DPP debts: The demand shall not have been issued unless insurer information had already confirmed the existence of a duplicate payment. For ALL Debt types: MSP Contractors shall bring closure (e.g., apply and/ or respond) to all checks related to established debts, posed defenses, waiver requests or compromise requests to a debt prior to the sending of an ITR to Treasury letter or the eventual referral to Treasury for cross- servicing, including the TOP. MSP Contractors shall document all actions taken on a debt after the demand (e.g., posting check, adjusting for a defense, etc.) in the HIGLAS system. MSP Contractors shall maintain all incoming correspondence and copies of outgoing correspondence within a case file. MSP Contractors that maintain case files and correspondence electronically shall ensure case retrieval or recreation take place within two (2) business days of a request.
Medicare Secondary Payer Manual (Pub. 100-05), Ch. 7 § 70.8: Validation of Possible Eligible Debts for Referral | Justis AI