Medicare sending employer bill

[Guest tonjer]

An employer has received a bill from Medicare because Medicare paid as primary payer with respect to an employee. First, is the employer the appropriate party or should Medicare have sent the bill to the insurance carrier? My reading of the statute/regulations leads me to the conclusion that Medicare does not care what entity pays, so long as it gets paid... is this correct? If so, must the employer pay the bill then try and recover from its insurance carrier? Has anybody had any experience with this?

[Jbentz]

i have dealt with these on both the employer side and the insurance side and it is the insurance side that handles them. I would forward it to carrier. They will (should) research it and see if they did the pay the bill incorrectly as the secondary rather than the primary. If the money is not owed (the person is not covered at DOS, etc....) they can send the documentation to them.

[Mary C]

This is under the Medicare Secondary Payer act which has been around since the early 90's. Although most companies have fully insured plans, the Department of Health and Human Services and the Department of the Treasury (both of which are involved in sending out these Secondary Payer Medicare Reimbursement requests) ultimately hold the employer responsible for repayment. We've dealt with a number of these and even though the first notice for repayment went to the carrier, they are also sent to the employer, especially since the insurers did not respond when the requests first went out in the 90's. One agency actually told me I wasn't very good at my job because I did not keep on top of the insurer to get them to pay!