What is the Medicare Secondary Payer Act?
A4. The Medicare Secondary Payer Act gives rise to Medicare conditional payments. The Medicare Secondary Payer Act (MSP) is found at Section 1862(b) of the Social Security Act 42 USC 1395y(b)(2). Applicable regulations are found at 42 CFR Part 411(1990). The MSP provides that Medicare may not make payment for medical services or prescription drug therapy charges where payment has been made or can reasonably be expected to be made under a workers’ compensation law or plan of the United States or a Sate or under a liability, no-fault or group health policy. Under this authority Medicare has a priority right of recovery from the primary payer, as well as, from parties in receipt of third-party payments such as a beneficiary provider, supplier, physician, attorney, state agency or private insurer pursuant to 42 CFR 411.25(g).
