The Congress Should Consider Amending the Medicare Secondary Payer Provisions To Include Disability Beneficiaries
HRD-85-102
Published: Sep 30, 1985. Publicly Released: Sep 30, 1985.
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Highlights
Over the past several years, Congress has amended the Social Security Act to require that, when beneficiaries between the ages of 65 and 70 and those with end stage renal disease are covered under employer-sponsored group health insurance, private insurance pays for medical services before Medicare. Because of congressional actions to make Medicare the secondary payer for other beneficiaries covered under group health plans, GAO estimated how much could be saved by extending these provisions to include disabled Medicare beneficiaries.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should consider extending the provision making Medicare a secondary payer to include working spouses' employer-sponsored group health insurance that covers disabled Medicare beneficiaries. If Congress does so, section 162(i)(1) of the Internal Revenue Code should also be amended to provide safeguards against possible discrimination against spouses of disabled beneficiaries by employer group health plans. |
Closed – Implemented
|
The Administration included this recommendation as a legislative proposal in its FY 1987 budget request. The legislative proposal was enacted by section 9319 of the Consolidated Omnibus Reconciliation Act of 1986. |
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Aid for the elderlyBeneficiariesHealth care cost controlMedicareHealth care costsHealth insurance cost controlMedical expense claimsPublic health legislationHealth insuranceHealth care