Centers for Medicare and Medicaid Services

Ensures Medicare pays only for services where it is the primary payer and that no other insurance or reimbursement payment options exist. Their work includes:

• Ensuring that Medicare gets repaid by the beneficiary for any conditional payments it makes related to a liability, no-fault, or workers' compensation case for parts A and B claims
• Identifying situations in which Medicare beneficiaries have other insurance that is primary to Medicare
• Collecting, managing, and reporting of other insurance coverage for beneficiaries
• Determining which insurance plan has the primary payment responsibility and the extent to which the other plans will contribute when an individual is covered by more than one plan
• Researching if Medicare or another plan or policy should pay first
• Recovering payments from beneficiaries made for them by mistake
• Updating databases about employer, no-fault and workers' compensation plans
• Creating Medicare Secondary Payer (MSP) records to keep Medicare from paying when it shouldn't
• Sharing data to the Medicare Beneficiary Database (MBD) for prescription drug benefit coordination

03/17/2026