Compliance with MSP Regulations

20.7 - Compliance with MSP Regulations (Rev. 99, Issued: 06-30-06; Effective/Implementation Dates: 10-02-06) Federal regulations at 42 CFR 489.20(h) requires you to pay Medicare within 60 days from the date you receive payment from another payer (primary to Medicare) for the same service. Submission of the CMS-838 and adherence to CMS’s instructions do not interfere with this rule. You must repay credit balances resulting from MSP payments within the 60-day period. Report credit balances resulting from MSP payments on the CMS-838 if they have not been repaid by the last day of the reporting quarter. If you identify and repay an MSP credit balance within a reporting quarter, in accordance with the 60-day requirement, do not include it on the CMS-838, i.e., once payment is made, a credit balance would no longer be reflected in your records. If an MSP credit balance occurs late in a reporting quarter, and the CMS-838 is due prior to the expiration of the 60-day requirement, include it in the credit balance report. However, payment of the credit balance does not have to be made at the time you submit the CMS-838, but within the 60 days allowed.