title: Changes to Medicare secondary payer provisions; Omnibus Budget Reconciliation Act of 1986--HCFA. General notice.
abstract: This notice describes how section 9319 of the Omnibus Reconciliation Act of 1986 (Pub. L. 99-509) affects the Medicare Program. Section 9319---Makes Medicare secondary for services furnished to disabled beneficiaries who are "active" individuals and are covered under large group health plans; Provides that the Federal Government may recover double damages from group health plans that fail to make primary payments as required by the law; Creates a private cause of action which provides double damages from primary payers that fail to make primary payments as required by the law; Provides special enrollment periods so that Medicare coverage can be restored promptly when group health plan coverage terminates; and Provides that in computing premium increases for late enrollment, periods of large group health plan coverage be excluded. The statutory changes made by section 9319 do not require regulations to implement because they are clear on their face as to what the Congress intended. Thus, we can put them into effect without first issuing regulations. Moreover, we have already had to apply these provisions because the congress made these changes applicable to services furnished on or after January 1, 1987. This notice will help to ensure that all affected parties are aware of the new provisions. This notice is not intended to be an exhaustive list of the changes, nor is it intended to represent the complete text of section 9319.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D003669:Deductibles and Coinsurance / Q000331:legislation & jurisprudence*; D007341:Insurance / Q000331:legislation & jurisprudence*; D007344:Insurance Claim Reporting / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D014481:United States