Medicare Secondary Payer Program

GAO provided information on and suggested language for proposed legislation regarding the recovery of health care costs from private insurers where Medicare is the secondary payer. GAO noted that the: (1) proposed legislation would give a clearer statutory basis for existing Medicare regulations on cost recovery from private insurers, which were recently invalidated by a court ruling; (2) Department of Health and Human Services is also preparing a legislative proposal to address this issue and other Medicare issues; (3) government may have to refund millions of dollars in past recoveries and forego future recoveries because of the court ruling; and (4) court ruling barred recoveries from third party administrators and claims filed past the insurers' filing deadlines and before 1989.