November 30, 2016

Medicaid Coordination of Benefits


Medicaid Coordination of Benefits

 

The Centers for Medicare & Medicaid Services (CMS) has released important information for states on Medicaid Coordination of Benefits with third parties - the Coordination of Benefits and Third Party Liability (COB/TPL) in Medicaid 2016, a handbook that provides guidance on many COB/TPL subjects. The Handbook includes a COB/TPL overview, core concepts such as payer-of-last-resort status and assignment of rights to third party payments, Medicaid state plan requirements, ways to identify third parties, claims payment methodologies, COB for Medicaid beneficiaries with Medicare coverage, COB and Medicaid managed care, and recovery from casualty/tort settlements and from the estates of deceased Medicaid beneficiaries. This guidance will be updated as necessary. The Handbook also contains five training presentations on major COB/TPL topics.