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US · guidance

CMS Pub. 100-05, ch. 5, § 30.5

No-Fault Responses

activein force · 2026-08-25 – presentas-observed

The MSP Contractor conducts all no-fault investigations (See Chapter 3 and §10.8.1, above). If

Medicare is billed as primary payer, but the MSP Contractor indicates there is coverage under no-fault insurance and the provider did not submit a satisfactory explanation to the development

request concerning why Medicare is billed as primary, the A/B MAC and the DME MAC denies the

claim.

History

(Rev. 11550; Issued: 08 -12-22; Effective: 10 -13-22; Implementation:10 -13-22)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
e399127f281f95585beb9b95d9481378d49b8654a3d6e12b206d951c85721372
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