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Medicare Secondary Payer Program: Identifying Beneficiaries with Other Insurance Coverage Is Difficult

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Report Type Reports and Testimonies
Report Date April 2, 1993
Report No. T-HRD-93-13
Subject
Summary:

Under the Medicare secondary payer program, Medicare costs have been cut by billions of dollars. This effort has centered on (1) identifying working beneficiaries and their spouses whose other health insurance is the primary payer to Medicare and (2) recovering Medicare payments that should have been made by private insurers. To achieve these goals, however, Medicare relies on a process that is labor intensive, expensive, and often unreliable. Enforcing the Medicare secondary payor provisions has been a long-standing challenge, and despite efforts by the Health Care Financing Administration and the millions of dollars spent to identify primary payers, hundreds of millions of dollars go uncollected.

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