100-05 Medicare Secondary Payer Manual: Chapter 1 Crosswalk

Medicare Secondary Payer (MSP) Manual
Chapter 1 - Background and Overview
Crosswalk
New
Chap
New
Section
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
HHA
Pub. 11
SNF
Pub. 12
PMs 	Subject
1 	10 	A3-3418.2
A3-3491
A3-3491.12
B3-3328
B3-3329.1C
HO-263
HO-263.12
HO-264.12
HHA-252.13 	SNF-335.12
SNF-336
SNF-336.12
AB-97-14 	General Provisions
1 	10.1 	A3-3491 	B3-3328.A.1
B3-3329.1.A
HO-262.2
HO-263
HO-263.1
HO-264
HHA-251.2
HHA-253
HHA-253.1
HHA-252
SNF-332.2
SNF-336
SNF-336.1
SNF-335
Working Aged
1 	10.2 	A3-3490 	B3-3329.B
B3-3329.1
HO-264
HO-264.1
HHA-252.1 	SNF-335 	End-Stage Renal Disease (ESRD)
1 	10.3 	B3-3329.1.C 	SNF-337 	Disabled Beneficiaries Covered Under a
Large Group Health Plan (LGHP)
1 	10.4 	A3-3407 	B3-3328.4
B3-2370
HO-289 	HHA-250 	SNF-325 	Workers' Compensation (WC)
1 	10.5 	B3-3328.5
B3-2340
HO-262.8 	No-Fault Insurance
1 	10.6 	A3-3418
A3-3418.2.F
A3-3489
B3-3328.6 	HO-262 	HHA-251 	SNF-332 	Liability Insurance

New
Chap
New
Section
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
HHA
Pub. 11
SNF
Pub. 12
PMs 	Subject
1 	10.7 	A3-3491.9A
A3-3415
B3-3328.C
B3-2370.6B
B3-3333.A
HO-263.10
HO-289.21
HHA-250.20
HHA-253.10
SNF-330.1
SNF-336.10
Conditional Primary Medicare Benefits
1 	10.7.1 	A3-3491.9B 	B3-3328.C
B3-3338.3
HO-263.10 	HHA-253.10 	SNF-336.10 	When Conditional Primary Medicare
Benefits May Be Paid
1 	10.7.2 	A3-3491
A3-3491.9
B3-3328.C.2 	HO-263
HO-263.10
HHA-253
HHA-253.10
SNF-336
SNF-336.10
When Conditional Primary Medicare
Benefits May Not Be Paid
1 	10.8 	IM3497
IM3497.3
IM3497.4
B3-3328.18
B3-3328.19
When Medicare Secondary Benefits Are
Payable and Not Payable
1 	10.9 	A3-3491.6.C
A3-3408.1.B
B3-3328.10
B3-3328.10.A
B3-3328.10.B
HO-263.7
HO-289.12
HHA-253.7
HHA-250.12
SNF-336.7
SNF-327.1
Multiple Insurers
1 	20 	A3-3407.1
A3-3490.1
A3-3491
A3-3418.2
A3-3489.1
A3-3418.2
A3-3492
A3-3491.1C
A3-3218.2
IM3492
IM3497
IM3497.1
IM3497.6
A3-3492B3
B3-3329.2
B3-2370.1
B3-3328
B3-3340.2.D
B3-3338.2
B3-7080.1
HO-262.2
HO-262.8
HO-262.9
HO-263
HO-263.2
HO-264.2
HO-289.1
HHA-253.2
HHA-252.2
HHA-248.1
HHA-250.1
HHA-251.2
HHA-253
SNF-332.3
SNF-334.1
SNF-336
SNF-336.2
SNF-335.2
SNF-325.1
AB-00-27 	Definitions

New
Chap
New
Section
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
HHA
Pub. 11
SNF
Pub. 12
PMs 	Subject
1 	30 	A3-3489.8
A3-3490.15
A3-3492.G
A3-3489.9
A3-3407.10
A3-3491.16
B3-3328.1
B3-3338.8
B3-3328.12
B3-3338.9
B3-2370.11
HO-262.14
HO-262.15
HO-263.16
HO-264.16
HO-289.10
HHA-248.7
HHA-253.15
HHA-252.16
HHA-250.10
HHA-337
SNF-334.7
SNF-336.16
SNF-335.16
SNF-326.4
Beneficiary's Rights and Responsibility
1 	40 	A3-3491.8
A3-3418.1.A
A3-3418.1.B
A3-3490.9
A3-3490.10
IM3497.7
A3-3489.B
A3-3497.7
A3-3191.12
A3-3329.3
B3-3328.22
B3-3338.B
HO-262. 1
HO-262.8
HO-263.9
HO-264.12
HO-264.13
HO-263.12
HHA-252.13
HHA-253.9
SNF-336.12
SNF-335.12
SNF-335.13
SNF-336.9
Effect of GHPs Payments on
Deductible, Coinsurance, and
Utilization
1 	40.1 	B3-3328.22 	Crediting Deductible for Non-Inpatient
Psychiatric Services Rules Defining
Employees Covered by GHPs and
LGHPs
1 	50 	A3-3491.1.B
A3-3491.1.
A3-3492.B.3
A3-3492B3b
A3-3492B3c
B3-3329.3
B3-3329.3A
B3-3329.3B
B3-3336.8
B3-3329.3.C
HO-2632 	HHA-253.2 	SNF-336.2 	Rules Defining Employees Covered by
GHPs and LGHPs

New
Chap
New
Section
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
HHA
Pub. 11
SNF
Pub. 12
PMs 	Subject
1 	50.1 	A3-3491
IM3491
A3-3492.B3e
A3-3492.B3f
A3-3492.B3g
A3-3492.B3h
A3-3492.B3i
A3-3491.2
B3-3329.3D
B3-3329.3E
B3-3329.3F
B3-3329.3G
B3-3329.3H
B3-3329.3I
B3-3329.3k
B3-3336.7
B3-3336.6
HO-263 	HHA-253 	SNF-336 	Clarification of Current Employment
Status for Specific Groups
1 	60 	B3-3329.3J1
B3-3329.3J2
B3-3329.3J2.A
B3-3329.3J2b
B3-3329.3J3
Aggregation Rules Applicable to
Determine the Employer Size
1 	70 	B3-3329.5
B3-3329.5A
B3-3336.2
B3-3336.3
Prohibitions Applicable to Employers
Offering GHP Coverage
1 	70.1 	B3-3329.5 	Financial Incentives
1 	70.2 	A3-3491
IM3491.B2
B3-3336.3
B3-3329.6B
HO-263 	HHA-253 	SNF-336 	Discrimination in Offering Equal
Benefits for Older and Younger
Employees and Spouses
1 	70.3 	A3-3490.14 	B3-3329.6.C
B3-3335.2
Differentiation for ESRD

New
Chap
New
Section
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
HHA
Pub. 11
SNF
Pub. 12
PMs 	Subject
1 	70.3.1 	B3-3335.2D 	Paying Benefits Secondary to Medicare
1 	70.4 	A3-3491.1
A3-3490.14
IM3491.B.1
B3-3329.6A
B3-3335.2A
B3-3336.2
B3-3329.6D
HO-263.2 	HHA-253.2 	SNF-336.2 	Taking Into Account Medicare
Entitlement
1 	70.5 	B3-3335.2.C
B3-3329.6E
Permissible Distinctions in Coverage
Allowed a GHP or LGHP
1 	80 	A3-3496
A3-3492H
A3-3496
A3-3492
B3-3329.6.G
B3-3329.7
B3-3329.8
B3-3329.6I
B3-3329.5B
B3-3329.7
B3-3329.8
SNF-337 	Actions Resulting from GHP or LGHP
Nonconformance
1 	90 	A3-3490.14 	B3-3329.6G 	GHP or LGHP Actions to Document
Conformance
1 	100 	A3-3492.K
A3-3492J
IM3491C
B3-3329.5C
B3-3329.6H
HHA-337 	Referral to the Regional Office
1 	100.1 	A3-3490.14B 	Job Discrimination
1 	110 	A3-3495 	B3-3328.17 	Federal Government's Right to Sue and
Collect Double Damages