J11 Part A Medicare Secondary Payer (MSP ... - Palmetto GBA

Government ProgramsGovernment programs, such as researchgrants, have the primary responsibility forservices directly related to the particularfederal program.March 201110Department of VeteransAffairs (VA)Veterans who have benefits available underthe VA have the option of choosing Medicareor the VA as the primary payerNo payment may be made under Medicare forservices authorized by the VAMarch 201111Department of VeteransAffairs (VA)March 2011VA agrees to pay a provider for a specific service• Usually based on a service-connected condition• Provider bills the VA first• If the VA does not pay 100% of the charges, Medicarecan be billed secondary• If the VA denies the services, the provider should submitthe claim to Medicare primary• No conditional payment claim is neededIf the beneficiary chooses Medicare as primary, noclaim can be submitted to the VA124