Coordination of Benefits & Recovery Overview
Additional Web pages available under the Coordination of Benefits & Recovery section of CMS.gov can be found in the Related Links section below.
The Medicare Secondary Payer (MSP) program is in place to ensure that Medicare is aware of situations where it should not be the primary, or first, payer of claims. If a beneficiary has Medicare and other health insurance, Coordination of Benefits (COB) rules decide which entity pays first. There are a variety of methods and programs used to identify situations in which Medicare beneficiaries have other insurance that is primary to Medicare. Activities related to the collection, management, and reporting of other insurance coverage for Medicare beneficiaries is performed by the Benefits Coordination & Recovery Center (BCRC).
In certain situations, after a Medicare claim is paid, CMS receives new information indicating Medicare has made a primary payment by mistake. Based on this new information, CMS takes action to recover the mistaken Medicare payment. The BCRC is also responsible for the recovery of mistaken Liability, No-Fault, and Workers’ Compensation (collectively referred to as Non-Group Health Plan or NGHP) claims. If it has been determined that a Group Health Plan (GHP) is the proper primary payer, the Commercial Repayment Center (CRC) will seek recovery from the Employer and GHP. Together, the BCRC and CRC comprise all Coordination of Benefits & Recovery (COB&R) activities. The most current contact information can be found on the Contacts page. Additional information regarding the MSP program as well as COB and recovery activities can be found in the menu to the left.
CMS has made available computer-based training courses (CBTs), flowcharts, presentations and other informational material to assist you in understanding COB&R. It is recommended you always scroll to the bottom of each Web page to see if additional information and resources are available for access or download.
How to sign-up for Coordination of Benefits & Recovery Overview Web page updates
CMS provides the ability for you to be automatically notified when changes are made to the Coordination of Benefits & Recovery Overview web pages. If you have not already signed up for these notifications, please click the Subscription Sign-up for COB&R Overview Web Page Update Notification link in the Related Links section below to subscribe. When notifications and new information regarding Coordination of Benefits & Recovery are available, you will be notified. These announcements will also be posted to the What’s New page.
- Subscription Sign-up for COB&R Overview Web Page Update Notification - Opens in a new window
- Attorney Services - Opens in a new window
- Beneficiary Services - Opens in a new window
- COBA Trading Partners - Opens in a new window
- Employer Services - Opens in a new window
- Insurer Services - Opens in a new window
- Prescription Drug Assistance Programs - Opens in a new window
- Provider Services - Opens in a new window
- Mandatory Insurer Reporting For Group Health Plans - Opens in a new window
- Mandatory Insurer Reporting For Non Group Health Plans - Opens in a new window
- Workers Compensation Medicare Set Aside Arrangements - Opens in a new window
- Page last Modified: 07/09/2014 12:54 PM
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